July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Timing of Complete Absence of Polypoidal Lesions on ICG Angiography Following Aflibercept Monotherapy in Polypoidal Choroidal Vasculopathy
Author Affiliations & Notes
  • Voraporn Chaikitmongkol
    Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand, Amphur muang chiang mai, Thailand
  • Phit Upaphong
    Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand, Amphur muang chiang mai, Thailand
  • Direk Patikulsila
    Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand, Amphur muang chiang mai, Thailand
  • Pichai Jirarattanasopa
    Department of Ophthalmology, Prince of Songkla University, Songkla, Thailand
  • Janejit Choovuthayakorn
    Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand, Amphur muang chiang mai, Thailand
  • Nawat Watanachai
    Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand, Amphur muang chiang mai, Thailand
  • Paradee Kunavisarut
    Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand, Amphur muang chiang mai, Thailand
  • Mansing Ratanasukon
    Department of Ophthalmology, Prince of Songkla University, Songkla, Thailand
  • Patama Bhurayanontachai
    Department of Ophthalmology, Prince of Songkla University, Songkla, Thailand
  • Neil M Bressler
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Maryland, United States
  • Footnotes
    Commercial Relationships   Voraporn Chaikitmongkol, Allergan (R), Bayer (R), Bayer (F), Novartis (R); Phit Upaphong, None; Direk Patikulsila, Bayer (R), Novartis (R); Pichai Jirarattanasopa, Bayer (R), Bayer (F), Novartis (R); Janejit Choovuthayakorn, Allergan (R), Bayer (R), Novartis (R); Nawat Watanachai, Allergan (R), Bayer (R), Novartis (R); Paradee Kunavisarut, Bayer (R), Novartis (R); Mansing Ratanasukon, Bayer (R), Novartis (R); Patama Bhurayanontachai, Bayer (R), Novartis (R); Neil Bressler, Bayer (F), Novartis (F), Roche (F), Samsung (F)
  • Footnotes
    Support  Bayer grant for investigator initiated trial
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1151. doi:https://doi.org/
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      Voraporn Chaikitmongkol, Phit Upaphong, Direk Patikulsila, Pichai Jirarattanasopa, Janejit Choovuthayakorn, Nawat Watanachai, Paradee Kunavisarut, Mansing Ratanasukon, Patama Bhurayanontachai, Neil M Bressler; Timing of Complete Absence of Polypoidal Lesions on ICG Angiography Following Aflibercept Monotherapy in Polypoidal Choroidal Vasculopathy. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1151. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Complete disappearance of polypoidal lesions on ICG angiography following intravitreous aflibercept has been reported; however, the exact timing of this disappearance is not well characterized. Therefore, this study explored the timing of complete absence of polypoidal lesions on ICGA following aflibercept monotherapy in PCV.

Methods : Eyes with newly-diagnosed PCV, by EVEREST criteria, enrolled between April 2016 and December 2017, were included. Eligible eyes received 3 monthly aflibercept injections, then bimonthly injections until one year (or as often as monthly if subretinal or intraretinal thickening was seen on OCT). PDT with verteporfin was added if persistent thickening and worsening visual acuity despite 6 monthly aflibercept injections. ICGA performed at baseline and q8 weeks thereafter and monthly OCT images were graded by two ophthalmologists to determine polypoidal status as complete absence (regression), incomplete absence (partial regression in size or number of polypoidal lesions), or no absence (no regression). If disagreement, both graders came to consensus with open adjudication.

Results : A total of 40 PCV eyes (38 participants; 100% Thai, 61% female, mean [SD] age 64 [±8.3] years), presented with serous (15%), serosanguinous or exudative (66%), and massive hemorrhagic (18%) maculopathies. Baseline # of polypoidal lesions on ICGA were: 90% had ≥5 polypoidal lesions, 10% had 2-4 lesions. Ninety-five percent (38 of 40 eyes) received aflibercept monotherapy, and 5% (2 of 40 eyes) received aflibercept and subsequent PDT. Mean (SD) injection numbers were 8.5 [±1.1]. At 1 year, 55% (95%CI: 40%-70%) had complete absence, 20% (95%CI: 8%-32%) had partial absence, and 5% (95%CI: 0%-12%) had no regression. Of 22 eyes with complete absence, median (interquartile range) duration of complete absence was 3 months (2 to 6 months). Rate of complete absence (complete regression) at 2, 4, 6, 8, 10, 12 months was 50%, 9%, 18%, 5%, 9%, and 9%.

Conclusions : Following aflibercept treatments, most eyes with PCV had complete absence (complete regression) of polypoidal lesions on ICGA before 6 months, few had no absence at 1 year. These findings support consideration of aflibercept for PCV initially without PDT when the goal is both improving visual acuity and getting absence or regression of polypoidal lesions.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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