One-Year Real-World Outcomes of Switching to Aflibercept 8 mg in Eyes with Neovascular Age-Related Macular Degeneration: A Swiss Retina Research Network Report

INTRODUCTION: This multicenter, longitudinal, observational real-world study evaluated the efficacy and safety of switching to intravitreal aflibercept 8 mg (Afl 8) in pretreated eyes with neovascular age-related macular degeneration (nAMD) within the Swiss Retina Research Network. A total of 283 eyes from 245 patients previously treated with other anti-vascular endothelial growth factor (anti-VEGF) agents (aflibercept 2 mg, faricimab, and ranibizumab) were included, with 1-year efficacy outcomes analyzed in 246 eyes and safety assessed in all treated eyes. METHODS: We recorded demographics, baseline functional and anatomical parameters-including spectacle-corrected visual acuity (VA) and optical coherence tomography (OCT) data-treatment history and outcomes over 12 months after switching to Afl 8. The main outcome measures were change in VA, central subfield thickness (CST), presence of intra- and subretinal fluid (IRF/SRF) and pigment epithelial detachment (PED), treatment intervals, and adverse events. RESULTS: Twelve months after the switch to Afl 8, mean VA remained stable, while mean CST decreased from 329.1 to 302.8 µm (p < 0.001). The portion of eyes without retinal fluid increased from 29.9% at baseline to 47.5% after 12 months. In parallel, the mean treatment interval was extended by 32.3% from 7.1 to 9.4 weeks (p < 0.001). At 1 year, 35.4% of eyes reached intervals of 8-11 weeks, while 20.2% achieved intervals of 12 weeks or longer. Intraocular inflammation was reported in 11 cases (3.9%). CONCLUSIONS: In pretreated nAMD eyes with high treatment demand, switching to Afl 8 resulted in a significant anatomical improvement and longer treatment intervals in a majority of patients. These real-world results highlight the therapeutic potential of Afl 8, with no new or unexpected safety issues.