Comparison of two treatment patterns with aflibercept for neovascular age-related macular degeneration: a cohort study

Background: Age-releated macular degeneration (AMD) is a very prevalent disease worldwide and it is the most common cause of severe vision loss in developed countries. Choroidal Neovascularization (CNV), previously known as “wet AMD”, is the most aggressive form of AMD. Nowadays, new pharmacological therapies are being developed, such as anti-vascular endothelial growth factors (anti-VEGFs) that have changed the progression of the illness, but AMD is still a chronic disease. Aflibercept (Eylea®) is one of the most used drugs for treating CNV due to the good results in the latest clinical trials. There is still a lack of published data about the results in the group of patients with bilateral affection of CNV AMD. Objectives: The goal of this study is to determine if the concurrent treatment with Aflibercept (Eylea®) of both eyes in the same intervention has better results (a reduction of more than 5% of the fovea thickness measured by optical coherence tomography (OCT)) than treating each eye with one week of separation. Design: A multi-centric cohort study in the Ophthalmology Department of Hospital Universitari de Girona Doctor Josep Trueta (Girona), Hospital Santa Caterina (Salt), Hospital de Figueres (Figueres), Hospital Comarcal de Blanes (Blanes), Hospital de Palamós (Palamós) and Hospital d’Olot I Comarcal de la Garrotxa (Olot). Method: 85 patients with more than 50 years and bilateral NVC AMD from Girona province will be recruited in our study. The two cohorts are going to be done with the patients who receive the treatment with Aflibercept the same day and with those who refuse being treated the same day and are going to receive the injections with 7 days of separation. Each patient is going to be followed during one year since initiating the treatment. This prospective cohort study will be realized in 3 years at the area of Giron