Early shift from ranibizumab to aflibercept for resistant pigment epitelial detachment in classical choroidal neovascularization

AIM: To evaluate the therapeutic effect of aflibercept in patients with suboptimal response to ranibizumab therapy in the early period.METHOD: Thirty-eight patients with wet type age related macular degeneration(W-AMD)were involved in this study. Eighteen patients with suboptimal response were shifted to 3 doses monthly intravitreal aflibercept therapy(IVA)and left 20 patients with suboptimal response went on 3 more monthly intravitreal ranibizumab(IVR). All changes were evaluated with fluorescein anigography(FA)and optical coherence tomography(OCT).RESULTS: Preoperative mean visual acuity(VA)and central macular thickness(CMT)of patients were 0.84±0.47 logMAR and 360±84 μm, respectively. One month after last IVR and IVA treatments, VA of patients were 1.1±0.34(P=0.11)logMAR and 0.48±0.37(P=0.019)logMAR and CMTs were 300±79 μm(P=0.002)and 271±51 μm(P=0.002), respectively.CONCLUSION: To eliminate repeated therapy for patients with suboptimal response to ranibizumab therapy, aflibercept might be a good alternative for early visual rehabilitation.