PURPOSE: To report the results of switching treatment to vascular endothelial growth factor (VEGF) Trap-Eye (aflibercept) in neovascular age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) refractory to anti-VEGF (ranibizumab and bevacizumab). METHODS: This is a retrospective study involving 32 eyes from 29 patients; 18 were cases of neovascular AMD and 14 were cases of PCV. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) of spectral-domain optical coherence tomography were evaluated. RESULTS: BCVA and CMT improved from 0.58 to 0.55 (p = 0.005) and from 404 to 321 microm (p < 0.001), respectively, after switching to aflibercept. The 14 eyes that received 6 or more aflibercept injections remained stable at 0.81 to 0.81 and 321 to 327 microm (p = 1.0, 0.29), respectively, after 3 aflibercept injections. The 10 eyes that received 3 or more bevacizumab injections after 3 or more aflibercept injections worsened, from 0.44 to 0.47 and from 332 to 346 microm (p = 0.06, 0.05), respectively. The results showed similar improvement of BCVA and CMT in neovascular AMD and PCV. CONCLUSIONS: Aflibercept seems to be effective for improvement and maintenance of BCVA and CMT for neovascular AMD and PCV refractory to anti-VEGF. Switching from aflibercept back to bevacizumab treatment may not be a proper strategy.
Angiogenesis Inhibitors/administration & dosage ; Bevacizumab/administration & dosage ; Choroid/*blood supply ; Choroid Diseases/complications/diagnosis/*drug therapy ; Dose-Response Relationship, Drug ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Male ; Ranibizumab/administration & dosage ; Receptors, Vascular Endothelial Growth Factor/*administration & dosage ; Recombinant Fusion Proteins/*administration & dosage ; Retinal Neovascularization/complications/diagnosis/*drug therapy ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/*antagonists & inhibitors ; *Visual Acuity ; Wet Macular Degeneration/diagnosis/*drug therapy/etiology

PURPOSE: This study compared serum vascular endothelial growth factor (VEGF) concentration between patients given the bilateral and unilateral intravitreal injections of bevacizumab. METHODS: In a prospective manner, serum VEGF levels in treatment-naive patients with age-related macular degeneration who underwent bilateral or unilateral intravitreal injections of bevacizumab were investigated. After informed consent, peripheral blood was collected from in patients who underwent bilateral or unilateral intravitreal injection of bevacizumab before and 1 month after the injection. Serum VEGF levels were measured by enzyme-linked immunosorbent assay after centrifugation. In addition, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) before and 1 month after the injection were compared between each group. RESULTS: Twenty patients received bilateral injections (40 eyes) and 20 patients received unilateral injections. The VEGF concentrations (pg/mL) before the bilateral injection were 235.75 +/- 183.16 and 252.53 +/- 233.52 for the unilateral injection. They were significantly reduced to 153.88 +/- 113.26 and 189.42 +/- 251.72 after 1 month, respectively (p = 0.037 and 0.019), which are showing no significant difference between the two groups (p = 0.771). And there were no significant intergroup difference in pre- and postoperative BCVA and CRT. CONCLUSIONS: The bilateral simultaneous intravitreal injection of bevacizumab did not differ greatly from unilateral intravitreal injection in the influence on serum VEGF levels and the therapeutic outcome.
Angiogenesis Inhibitors/administration & dosage ; Antibodies, Monoclonal, Humanized/*administration & dosage ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Intravitreal Injections ; Macula Lutea/*pathology ; Macular Degeneration/blood/diagnosis/*drug therapy ; Prospective Studies ; Tomography, Optical ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors/*blood ; Visual Acuity

PURPOSE: This study compared serum vascular endothelial growth factor (VEGF) concentration between patients given the bilateral and unilateral intravitreal injections of bevacizumab. METHODS: In a prospective manner, serum VEGF levels in treatment-naive patients with age-related macular degeneration who underwent bilateral or unilateral intravitreal injections of bevacizumab were investigated. After informed consent, peripheral blood was collected from in patients who underwent bilateral or unilateral intravitreal injection of bevacizumab before and 1 month after the injection. Serum VEGF levels were measured by enzyme-linked immunosorbent assay after centrifugation. In addition, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) before and 1 month after the injection were compared between each group. RESULTS: Twenty patients received bilateral injections (40 eyes) and 20 patients received unilateral injections. The VEGF concentrations (pg/mL) before the bilateral injection were 235.75 +/- 183.16 and 252.53 +/- 233.52 for the unilateral injection. They were significantly reduced to 153.88 +/- 113.26 and 189.42 +/- 251.72 after 1 month, respectively (p = 0.037 and 0.019), which are showing no significant difference between the two groups (p = 0.771). And there were no significant intergroup difference in pre- and postoperative BCVA and CRT. CONCLUSIONS: The bilateral simultaneous intravitreal injection of bevacizumab did not differ greatly from unilateral intravitreal injection in the influence on serum VEGF levels and the therapeutic outcome.
Angiogenesis Inhibitors/administration & dosage ; Antibodies, Monoclonal, Humanized/*administration & dosage ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Intravitreal Injections ; Macula Lutea/*pathology ; Macular Degeneration/blood/diagnosis/*drug therapy ; Prospective Studies ; Tomography, Optical ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors/*blood ; Visual Acuity