Effectiveness of Continued Ranibizumab Therapy in Neovascular Age-Related Macular Degeneration versus Switch to Aflibercept: Real World Evidence  Usha Chakravarthy, MD, PhD, Vladimir Bezlyak, PhD, Alexandros Sagkriotis, MSc, Ray Griner, MPH, Adrian Skelly, MSc, David S. Boyer, MD, Fran Milnes, MSc  Ophthalmology Retina   DOI: 10.1016/j.oret.2018.09.001 Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 1 Flow chart showing patient populations through study. *One or more ranibizumab treatment and 1 or more VA reading after start date; 1 or more VA reading on or within 30 days of start date. nAMD = neovascular age related macular degeneration; DME = diabetic macular edema; M = month; mCNV = myopic choroidal neovascularization; RVO = retinal vein occlusion; VA = visual acuity; VEGF = vascular endothelial growth factor. Ophthalmology Retina  DOI: (10.1016/j.oret.2018.09.001) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 2 Illustration showing treatment initiation and follow-up in the switcher and nonswitcher cohorts. In all eyes initiated on ranibizumab (baseline), the switch to aflibercept could occur between month 3 and 23. For assessing visual acuity (VA) variables at different time points, baseline VA (letters) was defined as the latest record available within the 30 days before and including baseline date. Visual acuity at switch was defined as the latest record available within 30 days before and including the date of the first aflibercept injection. At month 3, VA was defined as the last VA reading performed at month 3 ± 1 month after baseline, but before or on the day of the first aflibercept injection. Visual acuity at month 24 was defined as the result of any assessment performed within month 24 ± 2 months’ time window after baseline. When more than 1 value was available, the value closest to the month of interest was considered. Ophthalmology Retina  DOI: (10.1016/j.oret.2018.09.001) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 3 Bar graph showing the number of treatment and nontreatment visits in matched cohorts. Data are mean injection frequency (standard deviation). Injection frequencies given as annualized counts. Switch cohort, n = 454; nonswitch cohort, n = 750. Ophthalmology Retina  DOI: (10.1016/j.oret.2018.09.001) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions

Figure 4 Graph showing the mean visual acuity (VA) at month 24 in matched cohorts. ETDRS = Early Treatment Diabetic Retinopathy Study; IQR = interquartile range. Ophthalmology Retina  DOI: (10.1016/j.oret.2018.09.001) Copyright © 2018 American Academy of Ophthalmology Terms and Conditions