Rishi Singh, MD, Management of AMD/DME - Episode 3

Patient Case #2: 73-Year-Old Female With nAMD

Rishi Singh, MD reviews the case of a 73-year-old female with treatment experienced neovascular age-related macular degeneration (nAMD).

Rishi Singh, MD: This is a 73-year-old woman with a past history of hypertension and obesity and a past ocular history of having exudative macular degeneration in the right eye, which is treated with 4 ranibizumab injections. She reports there's been no significant improvement in the vision since these injections have started. Her presenting visual acuity is 20/60. She's a former smoker. She does take a multivitamin and aspirin each day. There are no allergies and the review systems are noncontributory.

This is the initial picture of the patient where you can see on this patient there is a pigment epithelial detachment and a mild amount of retinal fluid present, and thus showing you have active choroidal neovascularization in this patient with prior ranibizumab injections over time.

Here you can see the color fundus photographs, which show some amount of subretinal hemorrhage present inferiorly with blocking. You also have what looks like a minimally plastic component nasal to the retina, the macular there, which might indicate the fact that this was either retinal angiomatous proliferation or a minimally classic lesion with hemorrhage from age-related macular degeneration.

Here's what happened to the patient during this treatment. This patient actually was in one study called the SWAP-2 study [NCT04483583]. It's where we actually got to use aflibercept for the first-line treatment of patients with neovascular AMD after being under other therapies. What we did in this case was give her 3 loading doses, which shows again how dramatically her vision has improved with 3 loading doses, but then it went every 8 weeks thereafter during the course of the study until the end of the trial.

Transcript Edited for Clarity