الفهرس 
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Abstract
AMD is a bilateral, progressive, degenerative disease of the central portion of the retina (the macula), affecting the photoreceptors and the retinal pigment epithelium (RPE) and may cause loss of central vision. There are two main types of AMD: non-neovascular (dry, atrophic, or nonexudative) or neovascular (wet or exudative) AMD (nAMD).
Choroidal neovascularization (CNV) which is the hallmark of neovascular or wet AMD is characterized by growth of abnormal fragile blood vessels into the subretinal space and consequent fluid and/or blood beneath the retina. These blood vessels grow throw breaks in Bruch‘s membrane and progress laterally between RPE and Bruch‘s membrane .CNV is the major cause of severe visual loss in patients with age related macular degeneration.
Anti-vascular endothelial growth factor (anti-VEGF) therapy is currently the treatment of choice for cases with neovascular AMD. The main purpose of this treatment is to suppress the activity of the CNV and reduce vascular permeability to prevent further visual acuity deterioration.
Aflibercept is the most recent anti-VEGF to gain approval by the FDA in November 2011 based on a comparison with ranibizumab in the VIEW 1 and VIEW 2 trials.
The aim of this study was to evaluate the efficacy of aflibercept intravitreal injection in treatment of CNV secondary to neovasular age related macular degeneration by measuring the early changes in BCVA and CMT.
The study was applied on 60 eyes of 46 patients suffering from neovascular age related macular degeneration (wet AMD).
Thirty-eight patients were males (50eyes) and 8 patients were females (10 eyes) with a mean age of 67.56±8.14 with range of 53-87 years.
All patients received 3 consecutive doses of 2 mg (0.05 mL) of aflibercept as intravitreal injection separated by 4 weeks under sterile aseptic technique. Patients were examined by FA & OCT at baseline, and by OCT after one month after each injection with follow-up of BCVA. Also changes in The NEI VFQ-25 scores between baseline and 4 weeks after the 3rd injection were measured.
At the end of followup mean of BCVA improved from 0.061 to 0.081. The mean CMT improved from 484.07 μm to 331.1.μm.
In this study, there was mild but not significant increase in IOP following injections. No serious drug related ocular or systemic adverse events were identified following the intravitreal injection.
As regard to NEI-VFQ-25, our data indicated that there was improvement of mean total score from 69.6±16.8 at baseline to 75±12.4after the 3rd injection of aflibercept. Also there was significant improvement in subscales of general vision, near activities, distant activities, mental health, dependency and role difficulties. While there was no significant improvement in color vision, ocular pain, driving and peripheral vision subscales.