Aflibercept polypoidal choroidal vasculopathy treatment : Result of a prospective study

Abstract

Purpose : Polypoidal choroidal vasculopathy (PCV) is a choroidal pathology with age-related macular degeneration similarities but characterized by a different prognosis due to frequent occurrences of sub retinal hemorrhages and to resistance to monotherapies such as Ranibizumab or Bevacizumab intravitreal injections (IVT). The current PCV management is based on treatments combining Verteporphin Phototodynamic Therapy (PDT) with Ranibizumab IVT. The purpose of this study is to evaluate both anatomical and functional efficacy of intravitreal injection of Aflibercept (IVTA) in monotherapy in PCV.

Methods : Prospective, multicentric study in patients with PCV naive or non-treated since 3 months with anti-VEGF or 6 months with PDT. All patients were treated with 3 initial monthly loading doses Aflibercept followed by a Q8 regimen during 28 weeks in total. All patients underwent a complete ophthalmic examination including, measurement of Early Treatment Diabetic Retinopathy Study (ETDRS) best- corrected visual acuity (BCVA) before each IVT and after 28 weeks as well as was realized an optical coherent tomography (OCT) of the macula and polypoidal dilations. At baseline and 28 weeks the polypoidal dilations were analysed with indocyanine green angiography (ICGA)

Results : 35 eyes of 35 patients were included in this study. All patients were followed during 28 weeks and received 5 IVTA. The mean baseline BCVA was 55 letters. After 28 weeks a significant +13 letters in BCVA and a regression of exudative signs on OCT in all patients have been observed. In 50% of the cases, polypes disappearance was observed on ICG.

Conclusions : In this study, we showed that Aflibercept in monotherapy was able to provide both a significant visual gain and regression of polypoidal dilations. The use in monotherapy may contribute to reduce the hemorrhagic risk and atrophy linked to PDT.

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