Peripapillary Retinal Nerve Fibre and Ganglion Cell Layer Changes Following Intravitreal Aflibercept 8 mg Therapy in Neovascular Age-Related Macular Degeneration: A Longitudinal OCT Study.

Authors

Giulio Volpe, Matteo Bonanata, Arianna Peyla, Ludovico Ruscitti, Veronika Eggarter, Martina Pache, Arianna Paris, Moreno Menghini, Gabriela Grimaldi

Published in

Ophthalmology and therapy. Jun 24, 2026. Epub Jun 24, 2026.

Abstract

Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is the standard of care for neovascular age-related macular degeneration (nAMD) and other retinal vascular diseases. However, transient post-injection intraocular pressure elevations have raised concerns regarding potential cumulative effects on inner retinal structures, including the peripapillary retinal nerve fibre layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIP). As longitudinal evidence on the neuro-retinal structural safety of higher-dose formulations such as aflibercept 8 mg remains limited, this study evaluated 12-month changes in pRNFL and mGCIP thickness following intravitreal aflibercept 8 mg.
This single-centre, observational longitudinal cohort study included patients with nAMD treated with intravitreal aflibercept 8 mg or aflibercept 2 mg. Patients receiving aflibercept 8 mg were prospectively enrolled, while patients treated with 2 mg aflibercept were retrospectively identified. Spectral-domain optical coherence tomography was used to assess pRNFL and mGCIP thickness at baseline and at 3, 6 and 12 months. Longitudinal within-eye changes relative to baseline were analysed, alongside inter-eye comparisons with fellow untreated eyes and between-treatment group comparisons at 12 months.
Thirty-eight eyes from 35 patients were included. In eyes treated with aflibercept 8 mg, mGCIP thickness remained stable throughout follow-up, with no significant changes at 3, 6 or 12 months compared with baseline. At 12 months, mGCIP thickness was comparable between aflibercept 8 mg-treated eyes and fellow untreated eyes, as well as between aflibercept 8 mg and aflibercept 2 mg-treated eyes. Similarly, pRNFL thickness showed no significant global or sectoral changes over 12 months and did not differ between treatment groups.
Over 12 months of follow-up, intravitreal aflibercept 8 mg was not associated with significant thinning of pRNFL or mGCIP thickness, supporting its neuro-retinal structural safety in routine clinical practice.

PMID:
42340610
Bibliographic data and abstract were imported from PubMed on 24 Jun 2026.

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