A comparative analysis of brolucizumab and photodynamic therapy as second-line therapy for polypoidal choroidal vasculopathy

Abstract

Purpose : Evaluating twelve months outcomes between a combination therapy using photodynamic therapy (PDT) and intravitreal brolucizumab (IVBr) monotherapy as a second-line therapy for polypoidal choroidal vasculopathy (PCV) patients who did not respond to aflibercept or ranibizumab.

Methods : This retrospective, case-control study compared outcomes, including functional aoutcome and the need for additional treatments, between IVBr and PDT as second-line treatments for refractory PCV, after adjusting for potential confounders. E-values were used to evaluate the robustness of the results against confounders.

Results : In this study, twenty-two eyes were treated with IVBr, while twenty-four eyes underwent PDT. After the twelve-month follow-up, no significant differences were observed in the best-corrected visual acuity (BCVA) between the groups receiving second-line treatments. The BCVA were 0.49 ± 0.47 logMAR for the IVBr group and 0.34 ± 0.39 logMAR for the PDT group (P-value = 0.817, Mann-Whitney U test). Five eyes (20.8%) in the PDT group did not require any additional thrapy after the second-line treatment, and the adjusted odds ratio (OR) indicating no further treatment needed was 11.98 (P-value = 0.019, Multivariable logistic regression analysis). The E-value for the odds ratio was 23.44.

Conclusions : Both second-line treatments for PCV showed similar functional outcomes. Only in the PDT group were some patients who required no additional treatment following second-line therapy for a year.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.