{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:27:21Z","timestamp":1760956041219,"version":"3.37.3"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T00:00:00Z","timestamp":1587168000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T00:00:00Z","timestamp":1587168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000801","name":"Bayer HealthCare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000801","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Graefes Arch Clin Exp Ophthalmol"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Purpose<\/jats:title>\n<jats:p>The aim of this study was to investigate the outcomes of a fixed intravitreal aflibercept regimen in patients with vascular pigment epithelium detachment (vPED) secondary to age-related macular degeneration with refractory subretinal fluid.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A prospective, interventional case series involved 20 eyes of 20 patients with refractory subretinal fluid and vPED treated with at least three injections of intravitreal anti-VEGF prior to study inclusion. After study inclusion, patients were treated with three injections of intravitreal aflibercept 2\u00a0mg\/0.05\u00a0mL monthly followed by injections every 8\u00a0weeks. Best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) were evaluated at all visits. Fluorescein angiography and indocyanine green angiography were performed at baseline and quarterly. Primary outcomes were effectivity of a fixed treatment as measured in change in BCVA, PED greatest linear diameter (GLD), and PED height from baseline to month 12. In an additional post hoc analysis, vPED patients were differentiated into two groups: (1) vPED lesions that showed persistence of subretinal fluid throughout 1\u00a0year of treatment and (2) vPED lesions that showed complete resolution of subretinal fluid at least at one of the monthly performed OCT volume scans. Reflectivity values were determined in the subretinal pigment epithelium (RPE) compartment in OCT scans at baseline, month 6 and 12.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 18 patients completed the study protocol. The mean age was 74.8\u2009\u00b1\u200910.6\u00a0years, and six patients were female. The median BCVA of all patients was 72.0\u2009\u00b1\u20098.0 EDTRS letters at baseline and 72.5\u2009\u00b1\u20099.5 EDTRS letters at 12-month follow-up (<jats:italic>p<\/jats:italic>\u00a0=\u20090.7420). The median PED height in all patients as measured in the OCT images significantly decreased from 372.0\u2009\u00b1\u2009140.0\u00a0\u03bcm to 149.0\u2009\u00b1\u2009142.0\u00a0\u03bcm after 12\u00a0months of treatment (<jats:italic>p<\/jats:italic>\u00a0=\u20090.0020). Persistent subretinal fluid was present at every OCT control in six patients (group 1). Twelve patients showed resolution of subretinal fluid at least at one OCT control (group 2). Reflectivity values in the sub-RPE compartment in OCT scans were 41.48\u2009\u00b1\u20094.48 (group 1) and 42.62\u2009\u00b1\u200912.34 (group 2) at baseline (<jats:italic>p<\/jats:italic>\u00a0=\u20090.854) and 65.88\u2009\u00b1\u20096.74 and 50.87\u2009\u00b1\u200914.11 at month 12 (<jats:italic>p<\/jats:italic>\u00a0=\u20090.038).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Intravitreal aflibercept in refractory vPED leads to a significant reduction in PED height and disease activity as well as preservation of BCVA over 1\u00a0year. Persistent subretinal fluid was present in PED lesions with high values of reflectivity under the RPE, suggesting both a diffusion barrier and an increasing fibrovascular maturization of the choroidal neovascularization.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Trial registration<\/jats:title>\n<jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> Identifier: NCT03370380<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00417-020-04675-y","type":"journal-article","created":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T07:02:20Z","timestamp":1587193340000},"page":"1411-1417","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prospective PED-study of intravitreal aflibercept for refractory vascularized pigment epithelium detachment due to age-related macular degeneration: morphologic characteristics of non-responders in optical coherence tomography"],"prefix":"10.1007","volume":"258","author":[{"given":"C. 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Author FA has received a speaker honorarium from Bayer. Authors JT, NM, and FR declare that they have no conflict of interest. Author PH has received research grants from Novartis and Bayer; author NE has received research grants from Novartis and Bayer and has received a speaker honorarium from Heidelberg Engineering, Novartis, Bayer, Sanofi Aventis, Allergan, Bausch, and Lomb.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The sponsor had no role in the design or conduct of this research. The contents of this publication reflect only the author\u2019s views and not the views of the sponsor.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}]}}