One year outcome of treat and extend regimen of aflibercept for polypoidal choroidal vasculopathy

Abstract

Purpose :
To evaluate one year outcome of intravitreal injections of aflibercept using treat and extend regimen for polypoidal choroidal vasculopathy (PCV).

Methods :
62 treatment-naive PCV patients were retrospectively reviewed. The initial injection interval was 5 weeks. Three monthly or more aflibercept injections were administered until obtaining dry retina and the injection interval was extended by two weeks up to maximum 13 weeks. When a fluid recurrence occurred, the injection interval was shortened to the initial 5 weeks. Polypoidal vessels (polyps) were evaluated on indocyanine green angiography.

Results :
Mean log MAR visual acuity (VA) improved significantly from 0.25 at baseline to 0.19 at 12 months (p=0.032) in 61 eyes. Mean central foveal thickness was significantly lower at 12 months (219.6 µm) than at baseline (345.1 µm, P<0.001). The mean number of aflibercept injections to obtain dry retina was 3.5 (3-10) and the total number of the injections was 7.5 (6-10) during one year. The macula was dry in 53 (85.5 %), 48 (77.4 %) and 47 eyes (75.8 %) at 3, 6, and 12 months respectively. 24 eyes (38.7 %) had recurrences when the injection interval was extended. Eyes with recurrences had significantly lower rates of the complete occlusion of the polyps at 3 months (p=0.023) and at 12 months (p<0.001) than those without recurrences.

Conclusions :
Treat and extend regimen of aflibercept showed favorable visual and anatomical outcomes in PCV patients at one year. Presence or absence of complete polyp-regression may be a factor for predicting a recurrence during the injection-interval extension.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.