Abstract
Purpose To compare the efficacy between initial 3-monthly intravitreal conbercept monotherapy and combination intravitreal conbercept with photodynamic therapy (PDT) for polypoidal choroidal vasculopathy (PCV). Methods This is a retrospective, comparative study which involved 65 PCV eyes of 65 patients. According to the therapeutic regimen, the PCV patients were divided into two groups: 32 eyes with naive PCV received a PDT after the first intravitreal injection of conbercept (IVC) followed by pro re nata (prn) retreatment (combination group), and 33 eyes with naïve PCV received 3-monthly IVC monotherapy followed by prn regimen (IVC monotherapy group). All patients completed at least 6 months of monthly follow-up. Results At month 6, best-corrected visual acuity (BCVA) improved significantly (P < 0.05) in both groups compared with that at baseline; the mean changes of BCVA between the IVC monotherapy group and combination group have no significant difference (−0.22 ± 0.22 vs. −0.17 ± 0.22 LogMAR, P = 0.38). The central retinal thickness (CRT) decreased significantly in the two groups (P < 0.05), with no difference between the two groups (P = 0.24). The complete regression rate of polyps was 58.6% (17 out of 29 eyes) in the IVC monotherapy group and 80.65% (25 out of 31 eyes) in the combination group, respectively (P = 0.09, χ-squared test). The combination group required significantly fewer injections than the IVC monotherapy group (3.09 ± 0.89 vs. 3.67 ± 0.74, P = 0.006). Conclusion Conbercept monotherapy significantly improved visual acuity and effectively regressed polyps during 6-month follow-up time in the treatment of PCV.
Highlights
polypoidal choroidal vasculopathy (PCV) is defined as polypoidal lesions with or without branching vascular networks during early-phase indocyanine green angiography (ICGA) which is more prevalent in Asians as compared with whites [1]
The main treatment modalities include the combination of photodynamic therapy (PDT) with intravitreal injection of antivascular endothelial growth factor (VEGF) therapy and anti-VEGF monotherapy
The inclusion criteria were [1] treatment-naive PCV characterized by the presence of polyps with or without branching vascular network (BVN) in the posterior pole of ICGA [2], observed subretinal fluid (SRF) or intraretinal fluid (IRF) under examination of optical coherence tomography (OCT) or leakage on the examination of fluorescein angiography (FA) [3], and completed at least 6 months of monthly follow-up after the first treatment
Summary
PCV is defined as polypoidal lesions with or without branching vascular networks during early-phase indocyanine green angiography (ICGA) which is more prevalent in Asians as compared with whites [1]. The therapy for the treatment of PCV is necessary. The optimal treatment for PCV has not been determined. The main treatment modalities include the combination of PDT with intravitreal injection of antivascular endothelial growth factor (VEGF) therapy and anti-VEGF monotherapy. The EVEREST-II study showed us that after 12 months, combination therapy of ranibizumab plus PDT was noninferior and superior to ranibizumab monotherapy in terms of improvement of BCVA and regression of polyps. Combination therapy was recommended for the treatment of PCV [4]. The Fujisan study demonstrated that both initial and deferred PDT combined with intravitreal injection of ranibizumab to treat PCV achieved similar visual and anatomical improvements at 12 months. Initial PDT combination leads to significantly fewer additional treatments [5]
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