Intravitreal anti-VEGF injections make up a large proportion of the workload in ophthalmology clinics. Since the introduction of aflibercept with eight weekly injections there has been an option to use a treatment which may require less treatment, with potential cost implications in terms of staff and drug cost. This paper reports the visual outcomes and number of annual injections required in patients who received ranibizumab vs. aflibercept as first line treatment for neovascular age-related macular degeneration (nAMD), and is a retrospective chart review following the change of first line treatment in 2013. They found in the two sequential cohorts that best corrected visual acuity (BCVA) was comparable with 15% fewer injections compared to ranibizumab. This information may be useful in the planning and delivery of future intravitreal injection service for neovascular AMD.