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Shinichiro Doi, Yuki Morizane, Atsushi Fujiwara, Mio Hosokawa, Shuhei Kimura, Mika Hosogi, Fumio Shiraga; Characteristics of geographic atrophy in polypoidal choroidal vasculopathy patients treated with aflibercept for one year. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2652.
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© 2017 Association for Research in Vision and Ophthalmology.
Geographic atrophy (GA) has been reported to develop in exudative age-related macular degeneration (AMD) during anti-vascular endothelial growth factor (VEGF) therapy, with the Comparison of Age-related macular degeneration Treatments Trials (CATT) study reporting an incidence of 10.6% for GA after one year of VEGF therapy. However, GA in polypoidal choroidal vasculopathy (PCV) has not been well characterized. In this observational clinical study, we investigated the incidence, enlargement ratio and location of GA in PCV patients treated with intravitreal aflibercept (IVA) injections for one year.
We followed 50 eyes of 49 patients with PCV from their first IVA injections, administered either pro re nata or by a treat and extend regimen, for one year. The presence and location of GA was comprehensively evaluated by color fundus photography, fundus autofluorescence (FAF), optical coherence tomography, and fluorescein and indocyanine green angiography. The area of GA was measured using Region Finder (Heidelberg Engineering, Heidelberg, Germany) and ImageJ software.
The mean number (± SD) of IVA injections given in one year was 7.0 ± 3.0. GA was detected in 2 eyes (4.0%) before treatment and developed in a further 2 eyes (4.0%) during the study period. The mean area of GA in all eyes was 1.14 ± 0.6 mm2 at final examinations. The mean progression rate for GAs present before IVA treatment was 0.12 ± 0.04 mm2. GA occurred either at the polypoidal lesions or at the abnormal PCV vascular networks.
We found a lower incidence of GA in PCV than was reported for AMD by the CATT study. Clinicians need to pay attention to the development and progression of GA at polypoidal lesions or abnormal vascular networks during VEGF therapy, as this can signal the onset of severe visual loss.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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