Eighteen-month real-world outcomes of intravitreal aflibercept 8 mg in treatment-naïve neovascular age-related macular degeneration: a UK single-centre experience

Abstract Purpose Intravitreal aflibercept 8 mg was developed to extend treatment intervals and reduce injection burden in neovascular age-related macular degeneration (nAMD). We evaluated visual, anatomical, and durability outcomes over 18 months in routine clinical practice. Methods This retrospective observational study included 102 eyes of 95 treatment-naïve nAMD patients commencing aflibercept 8 mg at a UK tertiary centre. All eyes received three loading injections followed by a treat-and-extend protocol. Best-recorded visual acuity (BRVA), central subfield thickness (CST), intraretinal fluid (IRF), subretinal fluid (SRF), and macular haemorrhage were assessed at baseline, post-loading, 12 months, and 18 months. Linear and generalised mixed-effects models were applied. Results Mean patient age was 81.1 ± 6.5 years; 68.4% were female. Mean BRVA was 62.5 ± 12.4 letters at baseline, 67.5 ± 13.7 post-loading, 66.8 ± 15.3 at 12 months ( n = 102), and 65.5 ± 18.5 letters at 18 months ( n = 73). Mean CST was 317.1 ± 95.4 μm at baseline, 237.9 ± 45.2 μm post-loading, 236.3 ± 51.7 μm at 12 months, and 220.6 ± 32.2 μm at 18 months ( n = 73). At 12 months, 51.9% of eyes achieved treatment intervals of ≥ 12 weeks, increasing to 73.9% at 18 months. No cases of endophthalmitis were recorded. Conclusion Aflibercept 8 mg achieved sustained visual acuity, significant anatomical improvement, and progressively extended treatment intervals over 18 months in treatment-naïve nAMD within routine clinical practice, supporting its effectiveness in reducing treatment burden without compromising disease control.