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Master Thesis

Réponse visuelle et anatomique en condition de « vraie vie » du traitement par aflibercept chez les patients naïfs atteints de dégénérescence maculaire liée à l’âge exsudative

Abstract : Introduction: Age-related macular degeneration (AMD) is the leading cause of severe visual loss after age 50 years in developed countries. The introduction of anti-VEGF therapies revolutionized the treatment of neovascular AMD. Aflibercept is the latest anti-VEGF, which obtained marketing authorization. The objective of this study was to evaluate the visual and anatomical outcomes of aflibercept treatment for naïve patients with exudative AMD outcomes in real life conditions. Patients and methods: It was a retrospective study of patients diagnosed with wet AMD and treated with aflibercept in the department of Ophtalmology at the Hospital of Bordeaux between November 2013 and July 2015. All patients received an induction phase with 3 injections and a personalized monitoring at the discretion of the four retinologists of the department. A measurement of ETDRS best-corrected visual acuity (BCVA), a fundus examination and an OCT were performed at each visit. Data were collected at day 0, 3 months, 6 months, 9 months, 12 months, 18 months and 24 months. The total number of injections and visits over the entire follow-up period was recorded. The primary endpoint was the change in visual acuity over the monitoring period. Results: Forty-three eyes of forty patients, aged 77.7 years on average, were treated with aflibercept with a minimum of 3 months follow-up. 25 eyes were followed up 1 year and 5 eyes two years. At baseline, the mean best corrected visual acuity (BCVA) was 55.7 letters. Patients received an average of 7.5 injections the first year and 2.6 the 2nd year. The mean gain of visual acuity was 7.3 letters at 3 months, 6.2 letters at 12 months, and letters 6.8 at 2 years. Anatomically, the OCT data showed a decline of all parameters. The central macular thickness decreased 118,3μm to 3 months to 12 months and 136,4μm 65,5μm to 2 years. Conclusion: Visual acuity gain at 3 months was maintained at 12 months and at 2 years. The anatomical parameters also showed a similar trend. These visual acuity results are comparable to the VIEW 1 and 2 studies with better results compared to the prior real life studies for ranibizumab. We can get our patients results which are approaching the pivotal studies despite the use of different protocols, personalized and customized and longer monitoring intervals. Studies on larger samples, longer term and evaluating different treatment regimens would be interesting.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01356304
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Thursday, August 25, 2016 - 2:16:49 PM
Last modification on : Wednesday, August 23, 2017 - 4:29:29 PM
Long-term archiving on: : Saturday, November 26, 2016 - 2:43:45 PM

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Marie-Victoire Duval. Réponse visuelle et anatomique en condition de « vraie vie » du traitement par aflibercept chez les patients naïfs atteints de dégénérescence maculaire liée à l’âge exsudative. Médecine humaine et pathologie. 2016. ⟨dumas-01356304⟩

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