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Hyun Woong Kim, Joo Eun Lee, Jae Pil Shin, Woohyok Chang, Yu Cheol Kim, Sang Joon Lee, In Young Chung, Ji Eun E Lee; Effects of Aflibercept on Patients with Polypoidal Choroidal Vasculopathy: One-year results of VAULT Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):513. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate efficacy of aflibercept for treatment naïve PCV.
A prospective, single-arm, interventional case series. Three doses of initial monthly intravitreal aflibercept 2.0 mg injections were followed by every two month maintenance injections. At every visit, best-corrected visual acuity (BCVA) measurement using ETDRS chart, and spectral domain optical coherence tomography (OCT) were performed before the injections. Fluorescein angiography (FA) and Indocyanine green angiography (ICGA ) were obtained at baseline, month 3, and month 12. Primary outcome measure was the ratio of patients who maintained visual acuity without losing 15 ETDRS letters or more at month 12. Changes in ETDRS visual acuity, macular appearance on OCT, and polypoidal lesions on ICGA were also evaluated.
From 48 patients initially enrolled, 40 patients finished complete follow up and were included in the final analysis. Mean age was 67.0 years old (range; 44-84). Thirty five eyes (87.5%) did not lose visual acuity more than 15 letters at month 12. Mean ETDRS letter score showed significant improvement from 55.1 at baseline to 64.2 at month 12 (9.0 letters gain, p<0.001). Mean central macular thickness measured by OCT changed significantly from 365.2μm at baseline 253.6at month 12 (p<0.001). Complete dry-up of macular was seen in 32 (76.2%), 27 (64.3%), and 24 (60.0%) eyes at month 3, 6, and 12, respectively. Reappearance or increase of fluid was noted in 14 at month 6, and 16 patients at month 12. Complete polyp regression was achieved in 27 (64.3%) and 26 eyes (66.7%), at month 3, and 12, respectively.
Functional and anatomical outcomes were favorable after aflibercept intravitreal injection for PCV patients. However, fluid reaccumulation and new polyp formation was seen in one-third of the patients after extending treatment interval. Bimonthly injections may be suboptimal and more frequent injections are needed to maintain stable condition achieved by initial monthly injections in some of PCV patients.
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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