Purchase this article with an account.
Shigeyuki Ise, Masaaki Saito, Yukinori Sugano, Akira Ojima, Tetsuju Sekiryu; Choroidal Thickness in Polypoidal Choroidal Vasculopathy After Switching to Intravitreal Aflibercept Injection. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3910.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate the changes of the subfoveal thickness after switching to intravitreal aflibercept injection for polypoidal choroidal vasculopathy (PCV).
We retrospectively reviewed 42 eyes of 41 patients (32 men, 9 women; age range (mean), 60-86 (76.3) years) with PCV treated with aflibercept (2 mg/0.05 ml). All patients had resistant to ranibizumab defined as having persist sub or intraretinal fluid by optical coherence tomography (OCT) and no changed or declined visual acuity compared with the time of first injection of ranibizumab, in spite of receiving the ultimate three consecutive monthly intravitreal injections of ranibizumab after 12 months. The choroidal thickness was measured using Enhanced Depth Imaging (EDI) by positioning the instrument sufficiently close to the eye to obtain an inverted image. Intravitreal aflibercept was administered with three consecutive monthly injections as loading dose, followed by further injections bimonthly. All patients were followed up for at least 6 months at Fukushima Medical University Hospital.
The mean foveal choroidal thickness significantly decreased from 209 μm at baseline to 196 μm at month 1 (P<0.001), 182 μm at month 3 (P<0.0001) and 181 μm at month 6 (P<0.0001). The mean logMAR best-corrected visual acuity (BCVA) levels significantly improved from 0.39 at baseline to 0.32 at 6 months (P<0.001). The mean improvement in BCVA at 6 months from baseline was 0.70 lines. No patient had a decrease in the BCVA of three or more lines during any 6 months. The central retinal thickness significantly decreased from 255 μm at baseline to 174 μm at 6 months (P<0.0001). At month 6, 27 (62.8%) of 43 eyes had dry macula, 12 (27.9%) eyes had a serous retinal detachment and remaining 3 (7.0%) eyes had macular edema. There was no significantly difference between the choroidal thickness and the prevalence of dry macula. Of 30 eyes with polypoidal lesions at baseline, complete regression of polypoidal lesions were achieved in 15 (50%) eyes at 3 months. No complications or systemic adverse events developed.
The choroidal thickness in PCV eyes significantly decreased after switching to intravitreal aflibercept injection. Aflibercept may affect to choroid, which might enable to achieve higher prevalence of occlusion of polypoidal lesions compared with ranibizumab.
This PDF is available to Subscribers Only