Clinical Outcomes Of Different Subtypes Of Neovascular Age-Related Macular Degeneration During Aflibercept Treatment

Purpose: To prospectively evaluate the outcomes of different subtypes of neovascular age-related macular degeneration during intravitreal aflibercept monotherapy. Methods: Forty-four eyes of 44 patients with treatment-naive polypoidal choroidal vasculopathy (PCV, n = 12), hemorrhagic choroidal neovascularization (hCNV, n = 12), pigment epithelium detachment (PED, n = 11), or retinal angiomatous proliferation (RAP, n = 9) were included and followed for 12 months. All patients received intravitreal aflibercept monotherapy. Results: Mean visual acuity at baseline in PCV was 67 +/- 16 Early Treatment Diabetic Retinopathy Study letters (20/50 Snellen equivalent), in hCNV 55 +/- 21 (20/80), in RAP lesions 64 +/- 11 (20/50), and in PED 74 +/- 7 (20/32). At Month 12, visual acuity in PCV was 66 +/- 16 (20/50), in hCNV 69 +/- 17 (20/40), in RAP 68 +/- 12 (20/50), and in PED 69 +/- 18 (20/40). At the 12-month follow-up, visual acuity improved or was stable (+/- 5 letters from baseline) in 84% of eyes (37/44 patients), with hCNV showing the greatest mean visual acuity gain. Mean central retinal thickness in patients with PCV was 523 +/- 251 mu m, in hCNV 497 +/- 171, in RAP lesions 573 +/- 132, and in PED 541 +/- 158 and decreased to 310 +/- 91 mu m in PCV, 323 +/- 75 mu m in hCNV, 357 +/- 173 mu m in RAP lesions, and 422 +/- 150 mu m in PED. The mean area of atrophy increased from 2.0 +/- 3.6 mm(2) at baseline to 4.6 +/- 8.6 mm(2) at Month 12 (mean difference [95% confidence interval] -0.8 [-8.5 to 7.0], P = 0.8), with the greatest atrophy in patients with PED at Month 12. Conclusion: All subtypes of neovascular age-related macular degeneration showed anatomical improvement and stabilization of visual function during intravitreal treatment.