Short-Term Efficacy of Aflibercept 8 mg in Refractory Neovascular Age-Related Macular Degeneration: A Real-World Retrospective Case Series from Taiwan

Purpose Aflibercept 8 mg is a newly developed option for neovascular age-related macular degeneration (nAMD) class. This study explores the short-term effectiveness of aflibercept 8 mg in patients with refractory nAMD. Method : This retrospective case series analyzed patients with refractory nAMD who received aflibercept 8 mg at Taipei Veterans General Hospital between October 2024 and April 2025. The main outcomes assessed were changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) during the initial treatment period. Secondary outcomes included evaluation of subretinal fluid (SRF), intraretinal fluid (IRF), and alterations in pigment epithelial detachment (PED) height. Data were analyzed using nonparametric statistical methods. Result : This study included 12 eyes with refractory nAMD, 5 with refractory polypoidal choroidal vasculopathy (PCV), and 3 with refractory pachychoroid neovasculopathy (PNV), all treated with aflibercept 8 mg. Over a 3-month follow-up, no significant improvement in BCVA was observed, while CMT showed significant reductions at all time points. PED height also significantly decreased at the 1- and 3-month visits per Wilcoxon signed-rank test. Although SRF prevalence declined, the change was not statistically significant. A dry macula was achieved in 45% of eyes. Around half or more of the eyes showed a CMT reduction >50 μm, with proportions of 50.0%, 54.5%, and 57.1% at months 1, 2, and 3, respectively. Conclusion : Aflibercept 8 mg demonstrated favorable anatomical outcomes in patients with refractory nAMD. Further studies are warranted to identify factors associated with treatment response and optimize patient selection. Trial registration The retrospective study design obtained approval from the Institutional Review Board of Taipei Veterans General Hospital, and all study procedures adhered to the principles outlined in the Declaration of Helsinki. The need for informed consent was waived by the Institutional Review Board of Taipei