Aqueous vascular endothelial growth factor and aflibercept concentrations after bimonthly intravitreal injections of aflibercept for age‐related macular degeneration

Importance Clinical evidence supports the efficacy of bimonthly aflibercept injection for age‐related macular degeneration. Background The study aimed to evaluate aqueous vascular endothelial growth factor and aflibercept concentrations and the efficacy of bimonthly aflibercept in patients with age‐related macular degeneration. Design This study is a prospective, interventional case series. Participants Enrolled were 35 eyes with exudative age‐related macular degeneration from 35 patients. Methods Patients received three bimonthly intravitreal aflibercept without loading doses. We collected the aqueous humor just before each injection, measured vascular endothelial growth factor and aflibercept concentrations by enzyme‐linked immunosorbent assay and measured best‐corrected visual acuity and central retinal subfield thickness before and after the injections. Main outcome measures Aqueous vascular endothelial growth factor and aflibercept concentrations were measured. Results The vascular endothelial growth factor concentration was 135.4 ± 60.5 pg/mL (mean ± standard deviation, range 60.6–323.4) at baseline and below the lowest detectable limit in all eyes at month 2 and in 32 eyes at month 4 (P