Early Real-World Outcomes of Intravitreal Aflibercept 8 mg for Neovascular Age-Related Macular Degeneration in France: A Retrospective Study.
Abstract
INTRODUCTION The aim of this work is to evaluate the early real-world effectiveness, anatomical outcomes, and safety of intravitreal aflibercept 8 mg in neovascular aged-related macular degeneration (nAMD) eyes.
Methods
This retrospective single-center study included consecutive nAMD eyes treated with at least one aflibercept 8-mg injection between January 2025 and January 2026 in France. Primary outcomes were treatment interval extension and macular drying. Secondary outcomes included changes in best-corrected visual acuity (BCVA), central macula thickness (CMT), OCT biomarkers, and safety. Subgroup analyses were performed according to treatment status, responder profile, and prior anti-VEGF generation. In addition, baseline predictive factors associated with treatment interval extension, achievement of an interval ≥ 12 weeks, and dry macular status were evaluated. A sensitivity analysis was performed in eyes with ≥ 6 months of follow-up.
Results
A total of 338 eyes from 267 patients were included (82 treatment-naïve and 256 switched eyes), with a mean follow-up duration of 5.5 ± 3.3 months. In switched eyes, the mean treatment interval increased by +1.8 ± 2.4 weeks (p < 0.001), with significant gains in good responders (+ 2.7 weeks), frequent flyers (+ 0.7 weeks), and poor responders (+ 1.8 weeks) (all p < 0.001). Dry macula rates increased from 39.6% to 70.7% (p < 0.001). Among treatment-naïve eyes, 74.4% achieved a dry macula at the last visit and 97.4% at the 4-week interval following induction. In eyes with ≥ 6 months of follow-up, the interval increased by +1.6 weeks and remained significant (p < 0.001). OCT biomarkers significantly decreased during follow-up (p < 0.001), while BCVA remained stable.
Conclusions
Early real-world use of aflibercept 8 mg was associated with improved anatomical outcomes and extended treatment intervals in treatment-naïve and previously treated nAMD eyes, while maintaining stable BCVA and a favorable safety profile. These findings support its potential to reduce treatment burden in routine clinical practice.