Assessing the Anatomical and Functional Efficacy of Aflibercept on Wet ARMD: An OCT and Mferg Recording

Objective: To investigate the therapeutic efficacy of aflibercept on sub-foveal choroidal neovascularization due to Age-Related Macular Degeneration (ARMD). Methods: Fifteen patients (15 eyes) with sub-foveal choroidal neovascularization due to ARMD were treated with intravitreal aflibercept. The doses were monthly for the first three months, being repeated every three months after for one year, using 2 mg of intravitreal aflibercept. A total of six aflibercept injections were, finally, performed during the 12-month study. All patients underwent a complete ophthalmic examination, including the measurement of bestcorrected visual acuity, fundus examination, intraocular pressure measurement, fluorescein angiography, optical coherence tomography (OCT) scan and multifocal electroretinography (mfERG) recording, at the baseline and at the first, second, third, sixth, ninth and 12th month after the first injection of aflibercept. Two masked examiners evaluated the visual acuity based on standard Snellen charts. Results: Fifteen patients (15 eyes), of mean age 69.2 ± 4.9 years old, with sub-foveal choroidal neovascularization due to ARMD were participated in this study. The mean BCVA was 0.12 ± 0.08, 0.20 ± 0.10, 0.25 ± 0.1, 0.28 ± 0.1, 0.34 ± 0.14, 0.36 ± 0.14 and 0.40 ± 0.14 decimal, at presentation, 1st, 2nd, 3rd, 6th, 9th and 12th month, respectively. Significant differences in amplitudes but not in latencies of three rings were observed over time. Significant reductions were noted among the central retinal thickness measurements before intravitreal aflibercept and at 1st, 2nd, 3rd, 6th, 9th and 12th month (465.0 ± 161.4, 374.9 ± 139.5, 323.3 ± 113.8, 290.3 ± 85, 263.3 ± 69, 243.0 ± 60.6 and 226.9 ± 63.5, respectively). Conclusion: This is the first time that anatomical and functional improvement of the macula in patients with subfoveal choroidal neovascularization due to ARMD was shown objectively, based on OCT and mfERG recordings. In addition, the improvement of visual acuity was noted over time. Our study supports the fact that intravitreal use of aflibercept is safe and effective in treating sub-foveal choroidal neovascularization observed in patients with ARMD.