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Research Letters |

Dramatic Resolution of Choroidal Neovascular Abnormalities After Single Aflibercept Injection Following Years of Ranibizumab Use

Voraporn Chaikitmongkol, MD; Neil M. Bressler, MD
JAMA Ophthalmol. 2013;131(2):260-262. doi:10.1001/jamaophthalmol.2013.1733.
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Correspondence: Dr Bressler, Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N Wolfe St, Maumenee 752, Baltimore, MD 21287 (nmboffice@jhmi.edu).

Conflict of Interest Disclosures: Dr Bressler receives grant support from Abbott Medical Optics, Allergan USA, Bausch & Lomb, Bristol-Meyers Squibb, Carl Zeiss Meditec, ForSight Labs, Genentech, Genzyme, Lumenis, Notal Vision, Novartis Pharma, Optovue, Pfizer, Quark Biotech, and Regeneron Pharmaceuticals.

Funding/Support: This work was supported by unrestricted research gifts to the Retina Division, Wilmer Eye Institute, Johns Hopkins University and the James P. Gills Professorship (Dr Bressler) and to the Department of Ophthalmology, Faculty of Medicine, Chiang Mai University (Dr Chaikitmongkol).

Role of the Sponsors: The sponsors had no role in the design and conduct of the study; collection, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.

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Grahic Jump Location

Figure 1. Choroidal neovascularization. A, Choroidal neovascularization (arrowhead) and lasered area (arrow) in June 2005. B, Choroidal neovascularization growth, with bevacizumab initiated in 2006. C, Choroidal neovascularization growth (arrow), with ranibizumab administered in 2008. D, Before adding photodynamic therapy in 2010. E, After adding photodynamic therapy in 2010. F, Choroidal neovascularization growth (arrow) following brief observation in 2011.

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Grahic Jump Location

Figure 2. In July 2012, fluorescein leakage (A) and macular edema (B) persisted after 48 ranibizumab injections. In August 2012, 4 weeks after intravitreal injection of aflibercept, the fluorescein leakage dramatically decreased (C) and the macular edema dramatically decreased, scar (arrow) persisted, and outer retinal tubulation (arrowhead) was noted (D).

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