Short-term efficacy of intravitreal aflibercept in treatment-naive patients with polypoidal choroidal vasculopathy

Retina. 2014 Nov;34(11):2178-84. doi: 10.1097/IAE.0000000000000229.

Abstract

Purpose: To evaluate the functional and morphologic outcomes of patients with polypoidal choroidal vasculopathy who underwent intravitreal aflibercept treatment.

Methods: We prospectively studied all the treatment-naive patients with polypoidal choroidal vasculopathy who were scheduled to undergo intravitreal aflibercept between February 2013 and July 2013. The best-corrected visual acuity was compared before treatment and at 6 months after the initial treatment. Changes in the central foveal thickness, choroidal thickness, presence/absence of subretinal fluid, fibrin, pigment epithelial detachment, and subretinal hemorrhage were also evaluated. The regression of the polyps was assessed using indocyanine green angiography.

Results: A total of 16 patients were included in this study. A significantly better best-corrected visual acuity at 6 months was seen, compared with that at baseline (P = 0.041). The mean central foveal thickness significantly decreased from 417 ± 127 μm to 187 ± 50 μm (P < 0.001). The mean choroidal thickness also significantly decreased from 250 ± 63 μm to 217 ± 64 μm (P = 0.011). Overall, a complete resolution was obtained in 93.3% (14/15) of the cases with subretinal fluid, 75.0% (3/4) of the cases with fibrin, and 88.9% (8/9) of the cases with subretinal hemorrhage. Fifty-six percent (5/9) of the cases with pigment epithelial detachment obtained a complete improvement, whereas 33.3% (3/9) exhibited a partial decrease. The rate of polyp regression was 75.0% (12/16).

Conclusion: Intravitreal aflibercept was well tolerated and had improved the vision of treatment-naive patients with polypoidal choroidal vasculopathy when it was evaluated at short-term follow-up examinations. Intravitreal aflibercept might be associated with a high possibility of achieving involution of polyps and reducing exudative findings.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage*
  • Choroid Diseases / drug therapy*
  • Choroid Diseases / physiopathology
  • Female
  • Fluorescein Angiography
  • Fovea Centralis / pathology
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / drug therapy*
  • Peripheral Vascular Diseases / physiopathology
  • Prospective Studies
  • Receptors, Vascular Endothelial Growth Factor / administration & dosage*
  • Recombinant Fusion Proteins / administration & dosage*
  • Visual Acuity

Substances

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