Intravitreal Aflibercept for Wet AMD

Intravitreal administration of aflibercept was performed in a sterile laminar flow operating room following sterile surgical procedures. A 30-gauge needle was inserted from the superotemporal quadrant, 3.5 to 4.0 mm from the corneoscleral limbus, to inject 3-mg/0.075-mL aflibercept into the vitreous cavity. The injection was administered once every 4 weeks until the retina became dry (no evidence of IRF or SRF on OCT images). Since all eyes were not treatment-naive and had received an average of 4.9 (range, 3–10) ranibizumab or conbercept injections and a minimum of 3 injections within 3 months prior to switching to aflibercept, 3 to 5 loading doses of aflibercept were not considered.
When there was at least one of the following conditions, patients continued receiving aflibercept injections on an individualized basis as a modified or extended treatment regimen: recurrent or persistent IRF or SRF on OCT images, the appearance of new hemorrhage on color fundus photographic or ophthalmoscopic images, or decreased visual acuity as compared to the previous examination. Retinal pigment epithelial detachment (PED) was not an indication for further treatment.