Subfoveal choroidal thickness in polypoidal choroidal vasculopathy after switching to intravitreal aflibercept injection.
OBJECTIVE
To investigate the changes in subfoveal thickness after switching to intravitreal aflibercept injection for polypoidal choroidal vasculopathy (PCV).


METHODS
We retrospectively reviewed 66 eyes of 65 PCV patients (mean age 75.7 years) which were refractory to ranibizumab. The choroidal thickness was measured by optical coherence tomography (OCT) using an enhanced depth imaging technique. Intravitreal aflibercept (2 mg/0.05 ml) was administered with three consecutive monthly injections as a loading dose, followed by further injections bimonthly (every two months).


RESULTS
The mean subfoveal choroidal thickness significantly decreased from 203 μm at baseline to 171 μm at month 6 (P < 0.0001). The mean logMAR best-corrected visual acuity levels significantly improved from 0.40 at baseline to 0.33 at 6 months (P < 0.001). The central retinal thickness significantly decreased from 249 μm at baseline to 161 μm at 6 months (P < 0.0001). At month 6, 41 (62.1%) eyes had dry macula by OCT. Of 46 eyes with polypoidal lesions at baseline, complete regression of polypoidal lesions was achieved in 26 (56.5%) eyes at 3 months.


CONCLUSIONS
The choroidal thickness in PCV eyes significantly decreased after switching to intravitreal aflibercept injection. Aflibercept may help prevent choroidal neovascularization near or under the retinal pigment epithelium, which might help achieve greater occlusion of polypoidal lesions compared with ranibizumab.
Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan. masaaki@med.akita-u.ac.jp.|Department of Ophthalmology and Visual Sciences, Akita University Graduate School of Medicine, 1-1-1 Hondo Akita, Akita, 010-8543, Japan. masaaki@med.akita-u.ac.jp.
Masaaki
M
Saito
Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Mariko
M
Kano
Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Kanako
K
Itagaki
Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Shigeyuki
S
Ise
Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Kimihiro
K
Imaizumi
Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Tetsuju
T
Sekiryu
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D002829:Choroid / Q000473:pathology*; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D057915:Drug Substitution; D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011127:Polyps / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D000069579:Ranibizumab / Q000627:therapeutic use; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab
Aflibercept; Choroidal thickness; Polypoidal choroidal vasculopathy; Ranibizumab; Vascular endothelial growth factor