For many patients  with age-related macular degeneration (AMD)—as well as some other diseases—and eye care professionals looking to guard patients’ vision against a swift decline, Eyelea (aflibercept, Regeneron) is an effective treatment.1 However, some patients do not respond to the therapy. New research from Japan shows that these patients aren’t simply non-responders. They may, in fact, be impacted by choroidal vascular hyperpermeability; according to the study, aflibercept treatment failure was significantly associated with choroidal vascular hyperpermeability.2

The study, published in the British Journal of Ophthalmology, looked at 365 patients with AMD who underwent three monthly injections of the anti-vascular endothelial growth factor (VEGF) medication with follow-up for at least 12 months. Nineteen were classified as non-responders, patients exhibiting an increase in exudation or decreased central retinal thickness of less than 100µm. This group was significantly associated with choroidal vascular hyperpermeability on indocyanine green angiography and lower frequency of subretinal hyper-reflective materials on optical coherence tomography. Most (79%) of the non-responders were successfully treated with either intravitreal ranibizumab or photodynamic therapy in combination with aflibercept.2

 1. Thomas M, Mousa SS, Mousa SA. Comparative effectiveness of aflibercept for the treatment of patients with neovascular age-related macular degeneration. Clin Ophthalmol. 2013;7:495–501
2. Hara C, Wakabayashi T, Toyama H. Characteristics of patients with neovascular age-related macular degeneration who are non-responders to intravitreal aflibercept. Br J Ophthalmol. June 15, 2018. Accessed June 19, 2018.