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Purpose <p>To evaluate visual and anatomical outcomes after switching to aflibercept 8&#xa0;mg in eyes with neovascular age-related macular degeneration (nAMD), and to assess outcomes according to the clinical indication for switching.</p> Methods <p>Multicentre retrospective observational study including 300 eyes with nAMD previously treated with anti-vascular endothelial growth factor therapy and switched to aflibercept 8&#xa0;mg for non-response (n:74, 24.7%), suboptimal response (n:159, 53.0%), or durability-driven reasons (n:67, 22.3%). Longitudinal data from the 6&#xa0;months preceding the switch and post-switch visits at 3 and 6&#xa0;months were analyzed. The primary outcome was change in best-corrected visual acuity (BCVA, ETDRS letters) from the switch visit to the 3-month post-switch visit. Secondary outcomes included changes in central subfield thickness (CST) and retinal fluid status.</p> Results <p>During the pre-switch period, mean BCVA declined by − 1.9 ± 8.2 letters and CST increased. At 3&#xa0;months after switching, BCVA improved by + 2.0 ± 9.2 letters (95% CI, + 0.8 to + 3.2; <i>p</i> &lt; 0.01), with greater gains in eyes switched for non-response (+ 2.8 ± 12.6 letters). Mean CST decreased by − 45.3 ± 79.8&#xa0;µm (95% CI, − 55.4 to − 35.2; <i>p</i> &lt; 0.001), with corresponding reductions in retinal fluid. Anatomical improvements were more pronounced in eyes switched for non-response, whereas more modest but consistent changes were observed in suboptimal and durability-driven groups. Visual and anatomical outcomes were maintained at 6&#xa0;months.</p> Conclusions <p>In previously treated nAMD eyes, switching to aflibercept 8&#xa0;mg was associated with reversal of pre-switch anatomical worsening, reduction in retinal fluid, and modest visual gains. Greater responses were observed in eyes with inadequate pre-switch disease control, supporting its role as a treatment escalation strategy in clinical practice.</p>

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Switching to aflibercept 8 mg in neovascular age-related macular degeneration: real-world outcomes according to switch indication

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Daniele Veritti,
  • Valentina Sarao,
  • Marco Lupidi,
  • Pasquale Viggiano,
  • Marco Lombardo,
  • Mariacristina Parravano,
  • Maria Cristina Savastano,
  • Giacomo Boscia,
  • Enrico Borrelli,
  • Lisa Toto,
  • Asia Amelia Martin,
  • Alba Chiara Termite,
  • Giulia Ribezzi,
  • Enrico Nacciarriti,
  • Claudia Fossataro,
  • Eleni Nikolopoulou Gisotti,
  • Giovanni Neri,
  • Cesare Persavalli,
  • Francesco Boscia,
  • Cesare Mariotti,
  • Rodolfo Mastropasqua,
  • Michele Reibaldi,
  • Federico Ricci,
  • Stanislao Rizzo,
  • Alfonso Savastano,
  • Monica Varano,
  • Paolo Lanzetta

摘要

Purpose

To evaluate visual and anatomical outcomes after switching to aflibercept 8 mg in eyes with neovascular age-related macular degeneration (nAMD), and to assess outcomes according to the clinical indication for switching.

Methods

Multicentre retrospective observational study including 300 eyes with nAMD previously treated with anti-vascular endothelial growth factor therapy and switched to aflibercept 8 mg for non-response (n:74, 24.7%), suboptimal response (n:159, 53.0%), or durability-driven reasons (n:67, 22.3%). Longitudinal data from the 6 months preceding the switch and post-switch visits at 3 and 6 months were analyzed. The primary outcome was change in best-corrected visual acuity (BCVA, ETDRS letters) from the switch visit to the 3-month post-switch visit. Secondary outcomes included changes in central subfield thickness (CST) and retinal fluid status.

Results

During the pre-switch period, mean BCVA declined by − 1.9 ± 8.2 letters and CST increased. At 3 months after switching, BCVA improved by + 2.0 ± 9.2 letters (95% CI, + 0.8 to + 3.2; p < 0.01), with greater gains in eyes switched for non-response (+ 2.8 ± 12.6 letters). Mean CST decreased by − 45.3 ± 79.8 µm (95% CI, − 55.4 to − 35.2; p < 0.001), with corresponding reductions in retinal fluid. Anatomical improvements were more pronounced in eyes switched for non-response, whereas more modest but consistent changes were observed in suboptimal and durability-driven groups. Visual and anatomical outcomes were maintained at 6 months.

Conclusions

In previously treated nAMD eyes, switching to aflibercept 8 mg was associated with reversal of pre-switch anatomical worsening, reduction in retinal fluid, and modest visual gains. Greater responses were observed in eyes with inadequate pre-switch disease control, supporting its role as a treatment escalation strategy in clinical practice.