Real-World Outcomes after Switch to Aflibercept 8 mg in Neovascular AMD: Twelve Months Follow-up on 654 Eyes

Purpose: To evaluate 12-month outcomes following systematic switch to aflibercept 8 mg in previously treated eyes with age-related neovascular macular degeneration (nAMD). Methods: Eyes in a plateau phase (≥10 prior anti-VEGF injections) that were switched to aflibercept 8 mg were retrospectively evaluated. Treatment intervals, best corrected visual acuity (BCVA), central retinal thickness (CRT), and data on intraretinal fluid (IRF) or subretinal fluid (IRF) were assessed at switch and after 3, 6, and 12 months. Results: In total, 654 eyes from 567 patients were included (mean [SD] age 82.4 [7.4], 34.5 [21.5] injections per eye before switch). The proportion of eyes with dry maculae increased from 55% at switch to 76% at 3 months ( P <0.001), 73% at 6 months ( P <0.001), and 69% at 12 months ( P <0.05). Eyes treated at 3-5-week intervals declined from 46% to 18% at 12 months ( P <0.001). Eyes on 9-12-week intervals increased from 11% to 34% ( P <0.001). The mean treatment interval increased from 6.0 (2.1) to 7.8 (2.4) weeks ( P <0.001). Eyes with dry maculae at switch were extended by 2.6 (1.8) weeks ( P <0.001). The mean CRT decreased from 234.7 (49.7) to 223.5 (46.7) µm ( P <0.001). BCVA declined from 68.5 (12.2) to 67.3 (13.9) ETDRS letters in the overall cohort, and from 68.5 (12.3) to 66.6 (14.3) ETDRS letters in eyes with a dry macula at switch ( P < 0.001). Conclusion: Switching to aflibercept 8 mg improved anatomical outcomes and reduced the proportion of eyes on short intervals. A slight decline in BCVA was observed, warranting long-term follow-up.