\r\nMethods: This retrospective study included 33 eyes with nAMD that were switched to aflibercept after an inadequate response to bevacizumab. Best-corrected visual acuity (BCVA), fundus biomicroscopy, and optical coherence tomography (OCT) findings were assessed at baseline (E1), after the third bevacizumab injection (E2), and one month after the first aflibercept injection (E3). Changes across visits were analyzed, and factors associated with final visual acuity were evaluated using multivariable linear regression.

\r\nResults: BCVA was 0.84 ± 0.63, 0.93 ± 0.76, and 0.80 ± 0.71 logMAR at E1, E2, and E3, respectively, with no significant change across visits. Mean central macular thickness (CMT) was 538.7 ± 166.6 µm at E1, 559.7 ± 248.6 µm at E2, and 465.0 ± 202.4 µm at E3, demonstrating a significant reduction following the switch to aflibercept (E2 vs E3, p = 0.007). The prevalence of subretinal fluid decreased significantly from 54.5% at baseline to 21.2% at E3 (p = 0.016). Multivariable regression identified older age (β = 0.342, p = 0.038) and poorer baseline BCVA (β = 0.411, p = 0.015) as independent predictors of worse final visual outcomes.

\r\nConclusion: Aflibercept provided significant short-term anatomical improvement, including reductions in CMT and subretinal fluid, but did not result in significant visual acuity improvement during follow-up. These findings suggest that aflibercept may be an effective option for nAMD patients who are unresponsive to bevacizumab. Keywords : Aflibercept, bevacizumab, anti-VEGF, neovascular age-related macular degeneration, bevacizumab resistance