Intravitreal aflibercept for management of subfoveal choroidal neovascularization secondary to angioid streaks.

In this study, we reported the clinical results of switching from ranibizumab to aflibercept for the treatment of an insufficient responder with choroidal neovascularization (CNV) secondary to angioid streaks (AS). A 39-year-old female patient with CNV secondary to AS had bilateral persistent intraretinal and subretinal fluid on the optical coherence tomography despite prior intravitreal 0.5 mg ranibizumab injections. The therapy was switched to intravitreal injection of aflibercept. The patient received a loading dose of three intravitreal 2 mg aflibercept injections at 4-week intervals for both eyes. Morphological and functional effects were observed as early as 1-week after the first injection. After the third aflibercept injection, her visual acuity improved, intraretinal and subretinal fluid resolved, and central macular thickness reduced in both eyes. This is an early, but encouraging and promising result indicating that aflibercept might be a good alternative management for CNV secondary to AS that is insufficiently responding to prior ranibizumab injections.