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Introduction <p>To evaluate the early outcomes of aflibercept 8&#xa0;mg (afl8) treatment in patients with neovascular age-related macular degeneration (nAMD) previously treated with aflibercept 2&#xa0;mg (afl2).</p> Methods <p>A retrospective, observational, monocentric Swiss study. Patients with nAMD who had received ≥ 3 consecutive afl2 injections and switched to afl8 because of persistent or recurrent fluids, or to extend treatment intervals, were included in the study. All patients started a loading phase of 3-monthly afl8 injections, followed by a treat-and-extend regimen. Outcome measures included changes in best-corrected visual acuity (BCVA), maximal pigment epithelial detachment (PED) height, central subfield thickness (CST), optical coherence tomography (OCT) biomarkers quantified using artificial intelligence, and treatment intervals until month 6.</p> Results <p>Fifty-two eyes of 44 patients who concluded the loading phase were included in this analysis. Mean age was 80.2 ± 8.5&#xa0;years; 73% of patients were females. At month 6, BCVA was unchanged, PED and CST height experienced a significant decrease by – 18.5 ± 12.9&#xa0;μm (<i>p</i> = 0.0005) and – 14.0 ± 3.5&#xa0;μm (<i>p</i> = 0.0042), respectively. Volumes of intraretinal fluid (IRF), subretinal fluid (SRF), and PED decreased (IRF: 4.4 ± 15.6–3.8 nl; SRF: 15.7 ± 35.7–10.3 ± 34.0 nl; PED: 268.2 ± 423.2–252.2 ± 484.1 nl). Mean treatment intervals increased by 1.7 ± 0.5&#xa0;weeks from the last assigned interval and by 0.6 ± 0.2&#xa0;weeks from previous maximal fluid-free intervals after switching (<i>p</i> = 0.0005 and <i>p</i> = 0.18, respectively). One mild vitritis was observed and resolved with vitrectomy and topical drops without decreased visual acuity.</p> Conclusion <p>Our real-world study supports the potential short-term benefits of afl8 in improving anatomical and durability outcomes in patients with recurrent nAMD. These findings also highlight the added value of data-driven evaluations. Long-term studies are needed to confirm the effectiveness and durability of afl8 in this population.</p>

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Early Outcomes of Intravitreal Aflibercept 8 mg in Eyes Previously Treated with Aflibercept 2 mg for Neovascular Age-Related Macular Degeneration with AI-Based Biomarker Quantification

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月29日

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  • Nicolò Bartolomeo,
  • Konstantinos Kitsos Kalyvianakis,
  • Yannic Pannatier Schuetz,
  • Anna Chiara Nascimbeni,
  • Daniela Gallo Castro,
  • Baptiste Crozat,
  • Mamadou Pathé Barry,
  • Aude Ambresin

摘要

Introduction

To evaluate the early outcomes of aflibercept 8 mg (afl8) treatment in patients with neovascular age-related macular degeneration (nAMD) previously treated with aflibercept 2 mg (afl2).

Methods

A retrospective, observational, monocentric Swiss study. Patients with nAMD who had received ≥ 3 consecutive afl2 injections and switched to afl8 because of persistent or recurrent fluids, or to extend treatment intervals, were included in the study. All patients started a loading phase of 3-monthly afl8 injections, followed by a treat-and-extend regimen. Outcome measures included changes in best-corrected visual acuity (BCVA), maximal pigment epithelial detachment (PED) height, central subfield thickness (CST), optical coherence tomography (OCT) biomarkers quantified using artificial intelligence, and treatment intervals until month 6.

Results

Fifty-two eyes of 44 patients who concluded the loading phase were included in this analysis. Mean age was 80.2 ± 8.5 years; 73% of patients were females. At month 6, BCVA was unchanged, PED and CST height experienced a significant decrease by – 18.5 ± 12.9 μm (p = 0.0005) and – 14.0 ± 3.5 μm (p = 0.0042), respectively. Volumes of intraretinal fluid (IRF), subretinal fluid (SRF), and PED decreased (IRF: 4.4 ± 15.6–3.8 nl; SRF: 15.7 ± 35.7–10.3 ± 34.0 nl; PED: 268.2 ± 423.2–252.2 ± 484.1 nl). Mean treatment intervals increased by 1.7 ± 0.5 weeks from the last assigned interval and by 0.6 ± 0.2 weeks from previous maximal fluid-free intervals after switching (p = 0.0005 and p = 0.18, respectively). One mild vitritis was observed and resolved with vitrectomy and topical drops without decreased visual acuity.

Conclusion

Our real-world study supports the potential short-term benefits of afl8 in improving anatomical and durability outcomes in patients with recurrent nAMD. These findings also highlight the added value of data-driven evaluations. Long-term studies are needed to confirm the effectiveness and durability of afl8 in this population.