Abstract
Purpose :
To report treatment responses to intravitreal aflibercept (IVA) monotherapy in polypoidal choroidal vasculopathy (PCV).
Methods :
We retrospectively reviewed clinical records of 27 eyes in 27 patients (19 men; mean 67.2 y/o) who were newly diagnosed PCV and received 3 monthly IVA treatment and thereafter PRN retreatment for 9 months at the Medical Retina Division Clinic of the Department of Ophthalmology, Keio University Hospital, between Feburary 2013 and August 2014. Best corrected visual acuity (BCVA), optical coherence tomography (OCT) images, fluorescein and indocyanine green angiograms (FA and IA), and fundus findings were analyzed at baseline and year 1. Central macular thickness (CRT), central choroidal thickness (CCT), pigment epithelial detachment height (PEDH) and subretinal fluid height (SRFH) were measured, SRF area (SRFA) were analyzed using ImageJ in OCT images, and number of polyps were in IA. Wilcoxon signed-rank test was used to compare the results between at baseline and at year 1. Mann-whitney’s U test was used to analyze the baseline characteristics of the cases having following findings at year 1 compared with the rest of the cases; 1) BCVA improvement of more than 0.2 in logMAR, 2) CRT improvement of more than 100 μm, and 3) polyp disappearance. The study followed the tenets of the Declaration of Helsinki and was approved by the ethics committee at Keio University School of Medicine (2010002), and registered as UMIN000007649.
Results :
Mean BCVA and CRT were improved from 0.20± 0.22 to 0.083± 0.17, and from 395± 142 to 266± 105 μm, respectively (both p < 0.0001), and PEDH, SRFH, and SRFA were reduced (all p<0.05) at year 1. BCVA-improved group had worse BCVA and fundus hemorrhage (both p<0.005), CRT-improved group had larger CRT, SRFH, and SRFA (p<0.05), and polyp-disappeared group had worse BCVA (p<0.05) and fundus hemorrhage (p<0.005) at baseline.
Conclusions :
Mean BCVA and CRT were improved after IVA treatment. Baseline characteristics of BCVA-improved, or CRT-improved, or polyp-disappeared group at year 1 may help understand the effect of IVA, although further studies are required.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.