Citation

Al-Moasseb Z, Balaskas K (2018) Unusual Treatment Response to Aflibercept, after Ranibizumab Treatment Failure, in Peripheral Exudative Haemorrhagic Retinopathy. Int J Ophthalmol Clin Res 5:098. doi.org/10.23937/2378-346X/1410098

Copyright

© 2018 Al-Moasseb Z, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

CASE REPORT | OPEN ACCESS DOI: 10.23937/2378-346X/1410098

Unusual Treatment Response to Aflibercept, after Ranibizumab Treatment Failure, in Peripheral Exudative Haemorrhagic Retinopathy

Zeyad Al-Moasseb1* and Konstantinos Balaskas1,2

1Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK

2Moorfields Eye Hospital, City Road, London, EC1V 2PD, UK

Abstract

Background

To report a case of a peripheral exudative haemorrhagic retinopathy (PEHR) associated with treatment response to Aflibercept (Eylea®) and not Ranibizumab (Lucentis®).

Methods

The authors report 79-year-old women with PEHR who had persistent treatment resistance to Ranibizumab, with rapid improvements once switched to Aflibercept. Baseline visual acuity, subjective vision and measurements of anatomical disease were taken using macular optical coherence tomography, wide-field colour, fluorescein and indocyanine-green angiography images. Post-intravitreal injection response was measured using visual acuity, subjective vision and anatomical macular optical coherence tomography findings.

Results

Improvements in visual acuity, subjective vision and anatomical resolution of intra-retinal fluid, cysts and retinal thickness were observed by the first Aflibercept injection. Disease remission was maintained with treat-and-extend regimen over a 27-month treatment period.

Conclusion

This case report highlights the utility of Aflibercept and a treat-and-extend regimen in the management of PEHR, refractive to Ranibizumab. Further larger studies are required to provide evidence to the efficacy and treatment regimens of anti-VEGFs, including Aflibercept, in PEHR.