| Real-World Treatment Outcome of Intravitreal Ranibizumab and Aflibercept in Pseudophakic Eyes with Neovascular Age-Related Macular Degeneration |
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Seungmin Choi, Jinsoo Kim, Min Seon Park, Soonil Kwon, Bum-Joo Cho |
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Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Korea |
Correspondence:
Bum-Joo Cho, Tel: +82-31-380-3835, Fax: +82-31-380-3837,
Email: bjcho8@hallym.or.kr
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Received: 25 February 2026 • Revised: 1 July 2026 • Accepted: 24 July 2026 |
| Abstract |
Purpose
To evaluate the long-term real-world treatment outcome of intravitreal ranibizumab and aflibercept injections in pseudophakic eyes with neovascular age-related macular degeneration (nAMD), independently of the effect of cataract progression.
Methods
Medical records of pseudophakic patients with nAMD who were treatment-naïve, underwent intravitreal injection of ranibizumab or aflibercept between March 2010 and August 2023, and then were followed up for at least 1 year were retrospectively reviewed. Demographic and clinical variables, including visual acuity (VA), central subfield thickness (CST), and total number of injections, were analyzed to assess the risk of poor treatment outcome.
Results
A total of 93 treatment-naïve pseudophakic eyes from 93 patients were included, with 46 eyes receiving aflibercept injection. The mean VA improved from 51.0 letters at baseline to 57.4 letters at 3 months showing the greatest improvement, and then gradually declined to 53.0 letters, 52.9 letters, and 49.7 letters at 1, 2, and 5 years after the initiation of injections, respectively. In contrast, the mean CST significantly decreased from 351.2 ± 114.6 μm to 230.7 ± 93.5 μm at 3 months, followed by a mild increase to 271.8 ± 117.1 μm at 1 year, and remained stable at 271.4 ± 160.5 μm at 2 years. Thereafter, CST gradually decreased reaching 251.7 ± 125.2 μm by the fifth year. There were no statistically significant differences in VA or CST between the ranibizumab and aflibercept groups throughout the period. Factors associated with poor visual outcome defined as ≤ 35 letters at 3 years were solely limited to baseline VA.
Conclusions
For eyes with sustained long-term follow-up, the visual outcomes of pseudophakic patients with nAMD, unaffected by cataract progression, were maintained at a good level above baseline over 4 years after intravitreal injection in the real-world, while CST decreased consistently from 2 to 5 years after treatment. |
| Key Words:
Age-related macular degeneration, Anti-vascular endothelial growth factor, Long-term treatment, Pseudophakia, Treatment outcome |
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