Quantitative OCT Subanalysis of Eyes With Choroidal Neovascularization Switched From Multiple Injections of Bevacizumab or Ranibizumab to Intravitreal Aflibercept

BACKGROUND AND OBJECTIVE: To assess the early therapeutic response after switching from multiple injections of bevacizumab or ranibizumab to aflibercept in eyes with neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: SD-OCT scans of patients with neovascular AMD that was suboptimally responsive to multiple injections of bevacizumab or ranibizumab who were switched to aflibercept were analyzed. After segmenting these scans, the relevant volumes were computed and compared at the various time points by Student's t test. RESULTS: After switching to aflibercept, converse to the outcome of the last injection of bevacizumab or ranibizumab, statistically significant decreases of 0.32 mm(3) in neurosensory retinal volume, 0.08 mm(3) in subretinal fluid, and 0.56 mm(3) in pigment epithelial detachment were observed (P = .01, .04, and .001, respectively). The mean ETDRS visual acuity increased from 62 to 65 letters after switching (P = .04). These favorable outcomes were sustained after three monthly injections of the new drug. CONCLUSION: Switching to aflibercept therapy in eyes with persistent fluid after multiple intravitreal injections of bevacizumab or ranibizumab was associated with an early reduction in all fluid compartments and improvement in visual acuity.