Intravitreal Aflibercept and Ranibizumab Injections for Polypoidal Choroidal Vasculopathy

Abstract

To compare the effectiveness of intravitreal injection of aflibercept and ranibizumab for patients with polypoidal choroidal vasculopathy (PCV). Retrospective, interventional case series. Ninety-eight treatment-naïve PCV eyes were included. The eyes had received intravitreal aflibercept or ranibizumab injections. All patients were treated using an initial series of 3monthly loading injections, followed by further injections as required. The visual and anatomic outcomes of treatment were evaluated after 12months. The mean best-corrected visual acuity (BCVA) in the aflibercept-treated group (38 eyes), expressed as the logarithm of the minimal angle of resolution (logMAR), had decreased from 0.63 ± 0.49 to 0.44±0.37 after 12months of treatment (P= .012). Similarly, in the ranibizumab-treated group (60 eyes), the BCVA had decreased from 0.66 ± 0.43 to 0.49±0.36 (P= .018). The central foveal thickness had decreased in the aflibercept-treated group from 396 ± 167μm to 212 ± 144μm, and in the ranibizumab-treated group from 402 ± 198μm to 240 ± 183μm (P< .001 in both cases). However, there was no significant difference between the groups with regard to either BCVA improvement or decrease in central foveal thickness. Polyp regression was significantly more frequent in the aflibercept-treated group, occurring in 39.5% of eyes, than in the ranibizumab-treated group (21.6% of eyes; P= .007). In PCV patients, the visual acuity improvement achieved after 12months of intravitreal aflibercept did not differ significantly from that achieved using intravitreal ranibizumab. However, aflibercept treatment more often led to polyp regression than did treatment using ranibizumab.