Short-term Effects of the Aflibercept Biosimilar Afilivu® on the Retinal Nerve Fiber Layer in Neovascular Age-related Macular Degeneration

Purpose: We evaluated the short-term effects of the intravitreal aflibercept biosimilar Afilivu® on peripapillary retinal nerve fiber layer (pRNFL) thickness in patients with neovascular age-related macular degeneration (nAMD).Methods: This retrospective observational study included 23 eyes of 23 patients who received intravitreal Afilivu® injections for nAMD between July 2024 and April 2025. Changes in pRNFL thickness, central macular thickness (CMT), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were evaluated at baseline and 1 month after each injection.Results: Global pRNFL thickness did not exhibit significant changes at any follow-up time point. Of patients who received three injections, a transient decrease in pRNFL thickness was detected in the superior temporal (p = 0.043) and inferior nasal (p = 0.027) sectors after the second injection; however, this reduction was not sustained. CMT significantly decreased after the first injection (p = 0.012), whereas BCVA and IOP remained stable throughout the study period.Conclusions: Intravitreal administration of the aflibercept biosimilar Afilivu® did not result in clinically significant short-term changes in pRNFL thickness. These findings support the structural safety of Afilivu® and confirm its short-term tolerability in clinical practice.