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Takeya Kohno, Manabu Yamamoto, Akira Cho, Kumiko Hirayama, Ayako Yasui, Shinsuke Ataka, Michiko Hirabayashi, Kunihiko Shiraki; 2-year results of switching to aflibercept for polypoidal choroidal vasculopathy in patients refractory to ranibizumab. Invest. Ophthalmol. Vis. Sci. 2016;57(12):514.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study was to examine two year outcome of intravitreal injections of aflibercept (IVA) in patients with polypoidal choroidal vasculopathy (PCV) refractory to intravitreal injections of ranibizumab (IVR).
26 eyes of consecutive 26 patients, who had been treated previously with IVR with or without photodynamic therapy (PDT) more than one year but failed to resolve subretinal fluid (SRF), were reviewed. Loading treatment of IVA was composed of three monthly injections and additional monthly injections until disappearance of SRF on optical coherence tomography (OCT). After the resolution of SRF, IVA injections were done 1-2 month intervals based on presence or absence of SRF on OCT.
The mean decimal visual acuity was 0.27±0.30 at baseline (range, -0.2-0.8), 0.18±0.29 at month 12 （p=0.028）and 0.19±0.30 at month 24 (p=0.026). Mean central foveal thickness significantly decreased from 247.8±86.3 µm (range, 136-477) at baseline to 173.2±53.4 µm (range, 76-331) at 3 months (P<0.001); the decrease was maintained until 24 months (P<0.001). Mean numbers of IVA were 8.1±1.2 (range, 6-10) and 7.5±1.8 (range, 5-10) during years 1 and years 2, respectively. No recurrence of the SRF was seen in 9 eyes (37.5%) with bimonthly IVA. In the remaining 15 eyes (62.5%), SRF recurred and subsequent 2-month or less intervals of IVA were performed to obtain dry retina. Supplementary PDT, however, was required in 3 eyes (12.5%) during the years 2 and SRF remained in 8 eyes (33.3%) at 24 months.
The switching to IVA for PCV refractory to IVR therapy improved or maintained the visual acuity for 2 years. However, approximately 30 % of patients were refractory to IVA and failed to resolve SRF using 2-month or less intervals of IVA.
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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