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Toshiaki Hirakata, Yuko Nishikawa, Kaoru Fujinami, Ken Watanabe, Kazushige Tsunoda, Toru Noda, Kunihiko Akiyama; EFFICACY OF AFLIBERCEPT IN JAPANESE PATIENTS WITH POLYPOIDAL CHOROIDAL VASCULOPATHY INSENSITIVE TO RANIBIZUMAB TREATMENT. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3836.
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To report the short-term efficacy of aflibercept in Japanese patients who were diagnosed with polypoidal choroidal vasculopathy (PCV) and had poor responses to ranibizumab.
Eleven patients were identified at the National Tokyo Medical Center who had been diagnosed with PCV on fluorescein/indocyanine green angiography and had no marked response to or developed tachyphylaxis in response to ranibizumab. The average number (± standard deviation) of intravitreal ranibizumab (IVR) injections was 12.9 ± 10.9. Subsequently, all patients received intravitreal aflibercept (IVA) injections. The treatment protocol included three IVA injections monthly. To assess the drug efficacy, the following three clinical parameters were evaluated: best-corrected logarithm of the minimum angle of resolution visual acuity (VA), central retinal thickness (CRT), and fluid absorption/reduction subretinally or in the sub-retinal pigment epithelial (RPE) space. Spectral-domain optical coherence tomography was used to assess the second and third parameters. The baseline data were compared to those obtained at the first visit 1 month after the first IVA injection and the last visit 1 month after the third injection.
The average VA/CRT at baseline, the first follow-up visit, and the last follow-up visit were 0.45 ± 0.36/277.8 ± 66.7 microns, 0.44 ± 0.33 (p=0.7150)/210 ± 69.2 microns (p=0.012), and 0.38 ± 0.36 (p=0.2489)/241 ± 66.5 microns (p=0.109), respectively. Absorption/reduction of subretinal or sub-RPE fluid occurred in all 11 patients.
The efficacy of aflibercept has been documented predominantly on architectural changes in Japanese patients with PCV. A specific effect could be suggested for PCV, which presumably has a different pathophysiology from exudative age-related macular degeneration in Caucasian patients.
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