Abstract
Purpose :
Type 3 choroidal neovascularization (CNV) is a particularly severe form of exudative AMD characterized by an anastomosis between choroidal vascularization and retinal vascularization usually well-defined on indocyanin green angiography by a hot spot.
In this context, we aimed to evaluate the functionnal and anatomical outcomes of a fixed aflibercept intravitreal injections regimen in naive patients with type 3 CNV.
Methods :
Patients with type 3 CNV underwent best-corrected visual acuity (VA) measurement, fundus examination, fluorescein angiography, indocyanin angiography and SD-OCT.
Treatment protocol was 3 monthly intravitreal injections of aflibercept 2 mg followed by bimonthly injections.
The primary endpoint was VA at 12 months. The secondary endpoints were VA at 6 month and anatomical outcomes (sub-retinal or intra-retinal fluids, central macular thickness) at 6 and 12 months.
This study was approved by the ethics committee (ClinicalTrials.gov Identifier: NCT02320474).
Results :
26 naive patients with type 3 CNV were included in the study (18 women vs 8 men).
At inclusion, the mean age was 82,4 ± 7.7 years, the mean VA was 59.8 ± 12.8 ETDRS letters and the mean macular thickness was 432 ± 95 µm on the studied eye.
On SD-OCT scans, intra-retinal cysts were observed in 92% and sub-retinal fluid was reported in 69% of patients.
The final primary and secondary endpoints will be presented during the meeting.
Conclusions :
Type 3 CNV is considered as the most severe form of exudative CNV because of the higher risk of bilaterality and of the importance of exudation associated with this form.
In this context, a fixed treatment regimen could have an advantage compared to a treat and extend protocol, because it could allow earlier detection of a fellow eye involvement.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.