Abstract

BackgroundTo investigate the one-year visual and anatomical outcomes of combination therapy with intravitreal aflibercept (IVA) and photodynamic therapy (PDT) for treating polypoidal choroidal vasculopathy (PCV).MethodsThis was a retrospective case-series study, including 30 eyes from 30 patients with treatment-naïve PCV treated by combination therapy with IVA and PDT. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), complete polyp regression rate, and dry macula rate were recorded every 3 months during 12-month follow-up. Clinical factors associated with final visual outcome and retreatment were investigated.ResultsThe mean LogMAR BCVA was significantly improved from 0.73 ± 0.65 at baseline to 0.51 ± 0.60 (p = 0.01), and the mean CRT was also significantly improved from 339 ± 96 μm at baseline to 244 ± 43 μm at 12-month follow-up (p <  0.001). Complete regression of polypoidal lesions was 76.7%, and dry macula rate was 100% at 12 months. Better final BCVA was associated with younger age and better baseline BCVA (p = 0.02 and p <  0 001). The patients without complete polyp regression at 3-month follow-up were associated with retreatment (p = 0.03).ConclusionIn this study, combination therapy with IVA and PDT had significant visual and anatomical improvements to PCV patients during one-year follow-up. Better baseline BCVA and younger age were found to be associated with better visual outcome.

Highlights

  • To investigate the one-year visual and anatomical outcomes of combination therapy with intravitreal aflibercept (IVA) and photodynamic therapy (PDT) for treating polypoidal choroidal vasculopathy (PCV)

  • Better baseline visual acuity and younger age were found to be associated with better visual outcome

  • We retrospectively reviewed the medical records of 30 eyes from 30 patients with symptomatic subfoveal PCV that were treated with combination therapy of IVA and PDT at Far Eastern Memorial Hospital in Taiwan between August 2015 and December 2017

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Summary

Introduction

To investigate the one-year visual and anatomical outcomes of combination therapy with intravitreal aflibercept (IVA) and photodynamic therapy (PDT) for treating polypoidal choroidal vasculopathy (PCV). Polypoidal choroidal vasculopathy (PCV) is a subtype of exudative age-related macular degeneration (AMD), and is characterized by polyp-like aneurismal nodules with or without branching vascular networks (BVN) on indocyanine-green angiography (ICGA) [1]. Current treatment modalities for PCV include photodynamic therapy (PDT) and intravitreal injection of anti-vascular endothelial growth. PDT has favorable visual outcome and regression of the polyps in treating PCV [5]; it causes hypoxia in retinal pigment epithelium, leading to enhanced VEGF and angiogenesis [6]. AntiVEGF is beneficial in vision outcome, but the polyp regression rate is relative low for PCV [7]

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