Comparison between 1-year outcomes of aflibercept with and without photodynamic therapy for polypoidal choroidal vasculopathy: Retrospective observation study.

Kei Takayama,Michael Hamblin,Fuminori Haga,Keiko Kataoka,Hiroko Terasaki,Hiroki Kaneko,Taichi Tsunekawa,Kyoko Hattori,Eimei Ra,Yasuki Ito,Hiroshi Fukukita

doi:10.1371/journal.pone.0176100

Abstract

Polypoidal choroidal vasculopathy (PCV) is characterized by polyp-like choroidal neovascularization and a branching vascular network. Intravitreal aflibercept injection (IAI) or photodynamic therapy (PDT) is used for treatment. We retrospectively compared the 1-year outcomes of IAI monotherapy and its combination with initial PDT for PCV. Twelve eyes with naïve PCV received three IAIs and a single PDT after the first IAI and as needed injection (combination group); 11 eyes with naïve PCV received three IAIs and as needed injections (IAI group). Significant improvements in visual acuity after 2 months and in CRT after 1 month were maintained at 12 months in both groups (both P < 0.05); groups did not differ significantly at any time point. CCT significantly reduced after 3 and 12 months in the combination group (both P < 0.05) but not in the IAI group. A mean of 3.7 ± 0.9 and 5.6 ± 2.0 injections was administered to the combination and IAI groups, respectively (P = 0.013). Within a 1-year period, combination therapy was found to yield similar visual acuity and retinal structure improvements and maintenance as IAI monotherapy while requiring fewer IAIs.

Highlights

Polypoidal choroidal vasculopathy (PCV) is characterized by polyp-like choroidal neovascularization and a branching vascular network as well as the presence of hyper-fluorescent nodules detectable during early-phase indocyanine green angiography [1, 2]
Fluorescein angiography (FA) and indocyanine green angiography (ICGA) were performed for subjects requiring retreatment if exudative changes were observed on optical coherence tomography (OCT)
The baseline mean Best-corrected visual acuity (BCVA) were 69.1 ± 9.2 letters score in the combination group and 69.0 ± 13.2 letters score in the Intravitreal aflibercept injection (IAI) group

Summary

Introduction

Polypoidal choroidal vasculopathy (PCV) is characterized by polyp-like choroidal neovascularization and a branching vascular network as well as the presence of hyper-fluorescent nodules detectable during early-phase indocyanine green angiography [1, 2]. These characteristics are associated with serous exudation and subretinal hemorrhage, which lead to retinal pigment epithelium detachment and, occasionally, neurosensory retinal detachment [3,4,5]. Previous studies have demonstrated the efficacy of photodynamic therapy (PDT) and intravitreal anti-vascular. 1-year outcomes of IAI with and without PDT for PCV foundation The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

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