Comparison of anatomical and functional results of intravitreal aflibercept and ranibizumab treatment in wet type age related macular degeneration

Purpose: To evaluate and compare the anatomical and functional results of intravitreal aflibercept and ranibizumab in the treatment of choroidal neovascularization (CNV) caused by age-related macular degeneration. Materials and Methods: Between May 2015 and September 2017, this study retrospectively reviewed the cases diagnosed with CNV, those who have been applied at least 6 consecutive intravitreal ranibizumab or aflibercept injections, and those whose files were reviewed for at least 6 months of the follow-up period. Best-corrected visual acuity (BCVA) with Early Treatment Diabetic Retinopathy Study (ETDRS) chart, intraocular pressure (IOP), optic fundus findings, central macular thickness (CMT) with optical coherence tomography (OCT), a CNV type with fluorescein angiography have been determined every month and before each injection. In the sixth month, eyes that had at least 1 activation criterion were switched to the other drug, and when CNV activation was detected in remission eyes additional 6 injections were administered. Anatomical and functional changes were compared within each group itself and between the groups. Results: 38 eyes of 38 patients (19 aflibercept, 19 ranibizumab) were included in the study. The mean follow-up was 18.1 months in the aflibercept group and 22.3 months in the ranibizumab group. The increase in BCVA after injection was not statistically significant (p>0.05). In the sixth month, 3 or more row gains were detected in 6 (32%) eyes in the aflibercept group and 7 (37%) eyes in the ranibizumab group (p=0.732). In the first year, these values were 6 (35%) for the aflibercept group (n=17) and 5 (36%) for the ranibizumab group (n=14) (p=0.005). There was a statistically significant decrease in mean CMT in all control points (p <0.05) in the aflibercept group and only at the 6th month in the ranibizumab group (p=0.003). In the sixth month, 18 (95%) eyes in the aflibercept group and 14 (74%) eyes in the ranibizumab group were in remission (p=0.180). Conclusion: Aflibercept and ranibizumab were found to be effective in the treatment of CNV. When sufficient anatomical response is not achieved, drug switch may be effective. Keywords: Macular degeneration, ranibizumab, aflibercept, choroidal neovascularization.