Response to photodynamic therapy combined with intravitreal aflibercept for polypoidal choroidal vasculopathy depending on fellow-eye condition:2-year results

Mio Matsubara; Yoichi Sakurada; Atsushi Sugiyama; Yoshiko Fukuda; Ravi Parikh; Kenji Kashiwagi

doi:10.1371/journal.pone.0237330

Response to photodynamic therapy combined with intravitreal aflibercept for polypoidal choroidal vasculopathy depending on fellow-eye condition:2-year results

PLoS One. 2020 Aug 11;15(8):e0237330. doi: 10.1371/journal.pone.0237330. eCollection 2020.

Authors

Mio Matsubara¹, Yoichi Sakurada¹, Atsushi Sugiyama¹, Yoshiko Fukuda¹, Ravi Parikh^{2

3}, Kenji Kashiwagi¹

Affiliations

¹ Departments of Ophthalmology, Faculty of Medicine, University of Yamanashi, Kofu, Yamanashi, Japan.
² New York University School of Medicine, New York, NY, United States of America.
³ Manhattan Retina and Eye Consultants, New York, NY, United States of America.

Abstract

We investigated whether response to photodynamic therapy (PDT) with intravitreal aflibercept injection (IAI) for polypoidal choroidal vasculopathy (PCV) differs depending on fellow eye condition. A retrospective review was conducted for consecutive 60 eyes with PCV treated with PDT combined with IAI as well as 2-years of follow-up data. Fellow eyes were divided into 4 groups; Group 0: no drusen, Group 1; pachydrusen, Group 2; soft drusen, Group 3: PCV/fibrovascular scarring. Best-corrected visual acuity improved at 24-months irrespective of groups and there were no significant differences in visual improvement among treated eyes among the 4 groups. Within 2-years, 35 (58.3%) required the retreatment. The need for retreatment including additional injection and the combination therapy was significantly less in Group 1(12.5%) compared to the others (P = 0.0038) and mean number of additional IAI was also less in Group 1 compared to the others (P = 0.017). The retreatment-free period from the initial combination therapy was longest in Group 1 (23.6±1.1 months) (P = 0.0055, Group 0: 19.1±6.9, Group 2: 12.8±7.9, Group 3: 11.5±9.9). The need for retreatment was significantly different according to fellow-eye condition. Among PCV patients, pachydrusen in fellow eyes appear to be a predictive characteristic for a decreased treatment burden at 2 years.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Angiogenesis Inhibitors / administration & dosage*
Choroid / blood supply
Choroid / diagnostic imaging
Choroid / drug effects
Choroidal Neovascularization / diagnosis
Choroidal Neovascularization / drug therapy*
Female
Follow-Up Studies
Humans
Intravitreal Injections
Male
Middle Aged
Photochemotherapy / methods*
Receptors, Vascular Endothelial Growth Factor / administration & dosage*
Recombinant Fusion Proteins / administration & dosage*
Retinal Drusen / diagnosis
Retinal Drusen / epidemiology*
Retreatment / statistics & numerical data
Retrospective Studies
Risk Factors
Tomography, Optical Coherence
Treatment Outcome
Visual Acuity

Substances

Angiogenesis Inhibitors
Recombinant Fusion Proteins
aflibercept
Receptors, Vascular Endothelial Growth Factor

Grants and funding

This work was supported by Japan Society for the Promotion of Science KAKENHI Grant Number 23791972 (YS). The funder provided support in the form of salaries for authors but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Manhattan Retina and Eye Consultants has provided a salary for R.P. and did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.