Abstract
Purpose :
To determine the association of the branching vascular network area (BVNA) progression with the outcomes of combination therapy with intravitreal aflibercept (IVA) and verteporfin photodynamic therapy (vPDT) for polypoidal choroidal vasculopathy (PCV) and to examine factors that affect BVNA progression.
Methods :
This was a retrospective study for 31 eyes of 31 patients (10 females, mean ±SD age, 75.0±8.9 years) with PCV who underwent the combination therapy with IVA and vPDT and followed up for more than 24 months. BVNA was manually measured based on the indocyanine green angiography image (3 minutes), using the HRA-2 (Heidelberg Engineering) built-in software. The BVNA progression (BVNA+) was defined when the BVNA at the final imaging 24 months after therapy was 1.5 times or more larger compared with the pre-treatment BVNA. The primary outcome measures were the differences in changes of the mean best-corrected visual acuity (BCVA) and the mean number of treatments during the follow-up period between eyes with and without BVNA+. Moreover, the clinical characteristics that may affect the BVNA progression were evaluated with multiple logistic analyses.
Results :
There was no significant difference in the follow-up period between the eyes with (n=6) and without (n=25) BVNA+ (p=0.13). The patients with BVNA+ significantly had larger number of total treatments in the follow-up period than those without BVNA+ (13.3±7.6 vs 4.4±0.3, p=0.03), but had no difference in the changes of mean BCVA in the follow-up period as compared with those without BVNA+(0.09±033 vs -0.10±0.17, p=0.25). Moreover, large BVNA at baseline was significantly related to BVNA+ (p=0.01).
Conclusions :
The eyes with BNVA+ required significantly larger number of treatments. BNVA+ was significantly related to large BVNA at baseline. BVNA progression was likely to be an indicator of treatment resistance after IVA+PDT in the PCV patients.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.