A Pharmacokinetic Study: Ranibizumab, Aflibercept and the Effect of Vitrectomy.

Inclusion criteria * Adults of either sex aged 55 years and older * Active neovascular AMD in the study eye * Intravitreal dose of 0.5 mg ranibizumab or 2 mg aflibercept required, as per current clinical guidelines * Venous access that is sufficient to allow easy blood sampling on a frequent basis * Able to give written consent * Willingness to comply with all study procedures Exclusion criteria * Myopia greater than 8 dioptres in the study eye * Axial length of eye under 20mm or over 26mm * Aphakia in study eye * Pseudophakia with a defect in the posterior capsule * Glaucoma in study eye * Current renal dialysis * Presence of inflammatory eye conditions, such as uveitis, or systemic conditions likely to elevate CRP. * Intraocular surgery within 6 months of enrolment, except for routine phacoemulsification cataract surgery that may occur within 4 months of enrolment * Current treatment for wet age-related macular degeneration with an intravitreal agent other than ranibizumab or aflibercept in the study eye. Patients expected to change their anti-VEGF agent during the sampling period are also excluded. * Known significant allergy to ranibizumab or aflibercept * Participants who, in the opinion of the Investigator, would not be willing or able to comply with the study protocol or provide informed consent. * Patients with severe anaemia * Patients who have received anti-VEGF therapy in either eye within 8 weeks of enrolment, or who are likely to require anti-VEGF treatment in the fellow eye during the course of venous sampling. Note that the final venous sample at 4 weeks can be undertaken on the same day as an anti-VEGF injection, but must be taken prior to any injection. * Patients presently taking any topical (skin or eye), periocular, intraocular, local or systemic treatment with immunosuppressive or anti-inflammatory agents, such as steroids, steroid sparing agents, and NSAIDs. Patients who have received any of these agents within 2 months prior to enrolment are also excluded, as are those thought likely to receive these medications during the course of venous sampling.