Purpose: The aim of this study was to compare responses to aflibercept treatment in age-based groups of patients with macular edema following branch retinal vein occlusion (BRVO). Methods: Eighty-five patients with macular edema following BRVO were divided into 4 groups according to their age: Group I (i.e., 45- to 54-year-olds), Group II (i.e., 55- to 64-year-olds), Group III (i.e., 65- to 74-year-olds), and Group IV (i.e., 75- to 84-year-olds). Each patient received a loading dose of 3 monthly intravitreal aflibercept injections. The treatment response was evaluated with visual acuity (VA) and optical coherence tomography measurements of the central foveal thickness (CFT), outer nuclear layer thickness (ONLT), and photoreceptor layer thickness (PRLT) before treatment and 1 month after the first and third injections. Results: In Group I (n = 19), Group II (n = 25), Group III (n = 23), and Group IV (n = 18), the mean values of VA, CFT, ONLT, and PRLT improved significantly 3 months after treatment. Whereas VA improved the most in Group I, its improvement significantly decreased in each progressively older age group, as did the reduction of the CFT, ONLT, and PRLT values, all of which were greater in groups I and II. Furthermore, age significantly correlated with changes in VA, CFT, ONLT, and PRLT across all groups. Conclusion: The efficacy and effectiveness of aflibercept treatment decrease in patients with macular edema following BRVO as they age, most likely due to age-related changes in posterior ocular structures.

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