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Short-term efficacy of intravitreal aflibercept depending on angiographic classification of polypoidal choroidal vasculopathy
  1. Seongyong Jeong,
  2. Min Sagong
  1. Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
  1. Correspondence to Professor Min Sagong, Department of Ophthalmology, Yeungnam University College of Medicine, #170 Hyunchungro, Nam-gu, Daegu 42415, Korea; msagong{at}ynu.ac.kr

Abstract

Background/aims To compare the short-term efficacy of intravitreal aflibercept treatment according to the subtypes of polypoidal choroidal vasculopathy (PCV) based on indocyanine green angiography (ICGA).

Methods Twenty-nine patients (29 eyes) with treatment-naïve subfoveal PCV were consecutively enrolled in this institutional study. The subjects were classified into two subtypes (type 1, polypoidal choroidal neovascularisation (CNV), 16 eyes; and type 2, idiopathic PCV, 13 eyes) based on the presence or absence of both feeder and draining vessels on ICGA. Intravitreal aflibercept was administered at baseline and at 1, 2 and 4 months. The primary outcome was the polyp regression percentage after 3 monthly injections. Changes in the best-corrected visual acuity and subfoveal choroidal thickness (CT) were evaluated at 3 and 6 months.

Results The complete polyp regression percentage was higher in type 1 than type 2 patients after 3 monthly injections (81% vs 30%, p=0.008). Type 1 patients showed better visual improvement at 3 months (−0.34 vs −0.08 logarithm of the minimum angle of resolution (logMAR), p=0.050) and 6 months (−0.30 vs −0.10 logMAR, p=0.168) than type 2 patients. Although subfoveal CT was significantly decreased after injections in both groups, type 2 patients with a thicker choroid at baseline showed a greater decrease than type 1 patients (p=0.032).

Conclusions There was a difference in early treatment response with aflibercept between two subtypes of PCV. Type 1 polypoidal CNV showed better visual improvement with a higher percentage of polyp regression than type 2 idiopathic PCV.

Trial registration number NCT02597855, Results.

  • Retina
  • Neovascularisation
  • Macula
  • Treatment Medical

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