Purpose: To evaluate individualized intravitreal aflibercept regimens for treatment of neovascular age-related macular degeneration (nAMD)-related pigment epithelial detachment (PED).
Methods: This prospective, multicenter, nonrandomized study included 32 eyes with nAMD-related PED, treated with ranibizumab for ≥6 months. All patients received intravitreal aflibercept (2 mg/0.05 mL) at baseline (no loading phase) and subsequently treated pro re nata with monthly follow-up for 12 months. Outcome measures included visual acuity, central retinal thickness (CRT), PED height and area, and neovascular network size.
Results: At 12 months, aflibercept improved mean best-corrected visual acuity compared with baseline values (p>0.05); 50% of patients displayed complete resolution of intraretinal and/or subretinal fluid. Compared with baseline, significant decreases were observed for mean CRT and PED height (both p<0.01).
Conclusions: Aflibercept appears to induce anatomical improvement for at least 12 months after conversion from ranibizumab in patients experiencing nAMD-related PED. Significant reductions in both mean PED height and CRT were observed, although these changes were not necessarily related to significantly improved visual acuity scores. However, larger patient cohorts are required to extend and validate our results, and increased study duration would allow exploration of the potential long-term benefits and challenges of prolonged aflibercept use.