Comparison of intravitreal injections of Ranibizumab and Aflibercept in neovascular age related macular degeneration

Clinical relevance: Pivotal studies are based on strict treatment regimens of vascular endothelial growth factor blocking drugs in neovascular age-related macular degeneration. However, looser regimens with poorer results have been reported in real-world studies with various outcomes. This results in a search of more precise data to rely on in the management of patients with neovascular age-related macular degeneration.Background: The aim of this study is to analyse the real-world outcome of vascular endothelial growth factor blocking agents in neovascular age-related macular degeneration.Methods: This is a retrospective comparative study of treatment-naïve patients who received intravitreal aflibercept or ranibizumab administration for neovascular age-related macular degeneration for at least 12 months on an as needed regimen following a loading phase of three-monthly injections. Full eye examination and optical coherence tomography scans were provided at all visits. The drugs were compared on the basis of visual acuity, central macular thickness, and subfoveal choroidal thickness. The baseline optical coherence tomography features were analysed seeking a correlation with the outcome.Results: One hundred and forty-one eyes were enrolled. The mean age was 71.7 ± 8.5 years. Sixty-eight (48.2%) patients received aflibercept and 73 (51.8%) received ranibizumab injections. The mean number of injections was 6.5 ± 2.5. The mean number of injections were also similar between groups (6.4 ± 2.5 vs. 6.5 ± 2.6, respectively, p = 0.783). At one year, both drugs caused significant increase in visual acuity and decrease in central macular thickness and subfoveal choroidal thickness.Conclusion: In a real-world setting, aflibercept and ranibizumab yielded similar results at one year in the management of neovascular age-related macular degeneration.