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Min Sagong, Seongyong Jeong, Moohyun Kim, Sooncheol Cha, JunHyuk Son; Short-term efficacy of intravitreal afilibercept depending on subtypes of polypoidal choroidal vasculopathy: polypoidal choroidal neovascularization or idiopathic choroidal vasculopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):511.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the short-term treatment efficacy of intravitreal injection of aflibercept between polypoidal choroidal neovascularization (CNV) and idiopathic polypoidal choroidal vasculopathy (PCV).
Twenty nine patients (29 eyes) with treatment-naive subfoveal PCV were enrolled prospectively. All subjects were classified into two subtypes (type 1 polypoidal CNV: 16 eyes and type 2 idiopathic PCV: 13 eyes) based on the presence or the absence of both of a feeder and a draining vessels on indocyanine green angiography. All patients received intravitreal injection of aflibercept (2.0 mg) at baseline and months 1, 2 and 4. Primary outcome was polyp regression rate after 3 monthly loading injections. Changes of largest polyp diameter, best corrected visual acuity (BCVA), central macular thickness (CMT), largest pigment epithelium detachment (PED) height and subfoveal choroidal thickness (CT) were evaluated at each monthly follow-up for 6 months.
Complete polyp regression rate was significantly higher in type 1 than type 2 PCV after 3 monthly injections (81% vs 30%, P=0.020). Type 1 PCV showed better visual improvement at month 3 with higher frequency of dry macula than type 2 PCV (-0.34 vs -0.08 LogMAR, P=0.050). There was no significant difference between two groups in the frequency of dry macula and changes of largest polyp diameter, largest PED height, and CMT at month 6. Although subfoveal CT was significantly decreased with injections in both types of PCV, type 2 PCV with thicker choroid at baseline showed more decrease than type 1 PCV (-19.6 vs -43.5 μm, P=0.032) at month 3.
Our study demonstrated a difference in early treatment response with aflibercept between two types of PCV. Type 1 polypoidal CNV showed better visual improvement with higher rate of polyp regression than type 2 idiopathic PCV.
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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