Non-responsiveness to intravitreal aflibercept treatment in neovascular age-related macular degeneration: Implications of serous pigment epithelial detachment

Norihiro Nagai, Misa Suzuki, Atsuro Uchida, Toshihide Kurihara, Mamoru Kamoshita, Sakiko Minami, Hajime Shinoda, Kazuo Tsubota, Yoko Ozawa

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Abstract

The prognosis of neovascular age-related macular degeneration (AMD) has been improved by anti-vascular endothelial growth factor treatments, including intravitreal aflibercept (IVA) treatment. However, many patients remain incurable. In this study, we retrospectively evaluated non-responsiveness to IVA monotherapy at 12 months in 133 eyes of 133 AMD patients. Sixty-two patients were initially treatment-naive, and 71 had received other treatments before IVA (the treatment-switched group). Mean best-corrected visual acuity (BCVA) was improved in the treatment-naive group but not in the treatment-switched group, although mean central retinal thickness (CRT) decreased in both groups. The respective percentages of non-responders as determined by worsened BCVA in the treatment-naive and treatment-switched groups were 8.1% and 15.5%, and via fundus findings, they were 12.9% and 8.5%. Multivariate analyses adjusted for age, gender, CRT, and greatest linear dimension showed that serous pigment epithelial detachment (PED) at baseline was associated with non-responsiveness in both groups as determined by BCVA and by fundus findings, and fibrovascular PED measurements indicated no response as determined by fundus findings in the treatment-switched group. The results reported herein may assist the formulation of appropriate treatment protocols for AMD patients.

Original languageEnglish
Article number29619
JournalScientific Reports
Volume6
DOIs
Publication statusPublished - 2016 Jul 11

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Macular Degeneration
Visual Acuity
Therapeutics
aflibercept
Clinical Protocols
Vascular Endothelial Growth Factor A
Multivariate Analysis

ASJC Scopus subject areas

  • General

Cite this

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title = "Non-responsiveness to intravitreal aflibercept treatment in neovascular age-related macular degeneration: Implications of serous pigment epithelial detachment",
abstract = "The prognosis of neovascular age-related macular degeneration (AMD) has been improved by anti-vascular endothelial growth factor treatments, including intravitreal aflibercept (IVA) treatment. However, many patients remain incurable. In this study, we retrospectively evaluated non-responsiveness to IVA monotherapy at 12 months in 133 eyes of 133 AMD patients. Sixty-two patients were initially treatment-naive, and 71 had received other treatments before IVA (the treatment-switched group). Mean best-corrected visual acuity (BCVA) was improved in the treatment-naive group but not in the treatment-switched group, although mean central retinal thickness (CRT) decreased in both groups. The respective percentages of non-responders as determined by worsened BCVA in the treatment-naive and treatment-switched groups were 8.1{\%} and 15.5{\%}, and via fundus findings, they were 12.9{\%} and 8.5{\%}. Multivariate analyses adjusted for age, gender, CRT, and greatest linear dimension showed that serous pigment epithelial detachment (PED) at baseline was associated with non-responsiveness in both groups as determined by BCVA and by fundus findings, and fibrovascular PED measurements indicated no response as determined by fundus findings in the treatment-switched group. The results reported herein may assist the formulation of appropriate treatment protocols for AMD patients.",
author = "Norihiro Nagai and Misa Suzuki and Atsuro Uchida and Toshihide Kurihara and Mamoru Kamoshita and Sakiko Minami and Hajime Shinoda and Kazuo Tsubota and Yoko Ozawa",
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AU - Suzuki, Misa

AU - Uchida, Atsuro

AU - Kurihara, Toshihide

AU - Kamoshita, Mamoru

AU - Minami, Sakiko

AU - Shinoda, Hajime

AU - Tsubota, Kazuo

AU - Ozawa, Yoko

PY - 2016/7/11

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