The outcome of intravitreal aflibercept therapy in eyes with neovascular age-related macular degeneration and its effect on choroidal thickness

Purpose: To evaluate the outcome of intravitreal aflibercept therapy in eyes with neovascular age-related macular degeneration and its effect on choroidal thickness. Material and Method: In this study a total of 89 eyes of 76 patients with neovascular age-related macular degeneration who were underwent ophthalmic examination in our retina clinic in the department of ophthalmology, Cukurova University Medical Faculty Hospital and reserching between December 2012 and October 2016 were evaluated prospectively. The demographic characteristics, sistemic diseases, condition of lens, duration of treatment, findings of OCT and FFA were recorded. Patients were distribuded into two groups. Group 1 includes the patients who underwent primary intravitreal aflibercept, group 2 includes the patients who underwent another anti-VEGF therapy before the treatment of intravitreal aflibercept enjection for neovascular age-related macular degeneration. All patients were evaluated ophthalmologically before the enjection. The effectiveness of the treatment was studied by comparing the best corrected visual acuity (BCVA), central macular thickness (CMT) and choroidal thickness (CT) measured before and after injection. The association between aforementioned factors and change in BCVA, CMT and CT was investigated. Findings: Before the enjections BCVA's to the logMAR were 1,12±0,48 at group 1 and 1.07±0,56 at group 2. No statistically significant difference was observed between two groups in the terms of mean visual acuity before injection (p=0,647). After the injections BCVA's to the logMAR were 0,94±0,5 at group 1 and 0,98±0,53 at group 2. There was no statistically significant difference between two groups after the injections (p=0,555). The amount of change in visual acuity after injection was 0,18±0,34 (p=0,01) at group 1, it was statistically significant; 0,092±0,38 (p=0,131) at group 2, it was not statistically significant. No statistically significant difference was observed between two groups in the amount of change in visual acuity after injection (p=0,230). Before the injection basal CMT values were 454,96±207,9 µm (101-1000) at group 1, 454±195,3 µm (148-1039) at group 2. No statistically significant difference was observed between two groups (p=0,982). After the injections CMT values were 254,60±140,98 µm (100-708) at group 1, 270,63±115,42 µm (119-774) at group 2. No statistically significant difference was observed between two groups (p=0,686). The amount of change in CMT values were 200,35±216,13 µm at group 1, 183,36±203,4 µm at group 2. Both of them were statistically significant (p=0,00 ve p=0,00). No statistically significant direffence was observed between two group in the amount of change of CMT after injection (p=0,234). Before the injection basal CT values were 190,98±56 µm (100-384) at group 1, 197±52,52 µm (125-330) at group 2. No statistically significant difference was observed between two groups (p=0,592). After the injections CT values were 168,79±50,64 µm (98-302) at group 1, 174,92±47,59 µm (106-260) at group 2. No statistically significant difference was observed between two groups (p=0,14). The amount of change in CT values were 22,19±0,62 µm at group 1. It was statistically significant (p= 0,014). The amount of changes in CT values were 22,28±74,05 µm at group 2. It was not statistically significant (p=0,061). No statistically significant difference was observed between two group in the amount of change of CT after injection (p=0,586). No statistically significant difference was observed BCVA's change between gender (p=0,418, p=0,552) condition of lens (p=0,182, p=0,993), sistemic disease (p=0,326, p=0,959), presence of PED (p=0,855, p=0,103), condition of IS/OS (p=0,203, p=0,888) ve type of CNV (p=0,972, p=0,275) at group 1 and 2. No statistically significant difference was observed CMT's change between gender (p=0,543, p=0,955), condition of lens (p=0,793, p=0,879), sistemic disease (p=0,101, p=0,47), presence of PED (p=0,27, p=0,599), condition of IS/OS (p=0,243, p=0,304) and type of CNV (p=0,12, p=0,835) at group1 and 2. No statistically significant difference was observed CT's change between gender (p=0,568, p=0,449), condition of lens (p=0,615, p=0,084), presence of PED (p=0,561, p=0,561), condition of IS/OS (p=0,702, p=0,949) ve type of CNV (p=0,349, p=0,349 ) at group 1 and 2. Conclusion: Intravitreal aflibercept is an effective treatment both of the patients who underwent primary intravitreal aflibercept and the patients who underwent another primary before for neovascular age-related macular degeneration. Keywords: Aflibercept, anti-VEGF, choroidal thickness, neovascular AMD, OCT