title: Comparison of initial treatment between 3-monthly intravitreal aflibercept monotherapy and combined photodynamic therapy with single intravitreal aflibercept for polypoidal choroidal vasculopathy.
abstract: OBJECTIVE
  To compare the efficacy of two different initial treatment modalities on visual outcome, need for retreatment, and angiographic improvement during 12-month follow-up for polypoidal choroidal vasculopathy (PCV).
  
  
  METHODS
  A retrospective medical chart review was performed for 66 eyes from 66 patients with treatment-naïve PCV. Visual and angiographic improvements and the incidence of retreatment for recurrence or residual pathology were compared between two groups that underwent either intravitreal aflibercept injection (IAI) monotherapy (n = 33) or combined photodynamic therapy (PDT) with IAI (n = 33).
  
  
  RESULTS
  Best-corrected visual acuity improved significantly (P < 0.001) in both groups at each of the 3-monthly visits during the 12-month follow-up period, with no difference between groups at 12 months (P = 0.56). The relative risk of the need for retreatment was significantly lower in the combined PDT and IAI group than in the IAI monotherapy group (P = 0.007). Angiographic regression of polypoidal vascular lesions occurred more frequently in the combined PDT group than in the IAI monotherapy group at 3 (87.5 % vs 56.7 %) and 12 months (68.8 % vs 60.0 %) (p = 0.0065 and p = 0.47 respectively).
  
  
  CONCLUSIONS
  The combination of PDT with IAI as the initial treatment for PCV may be superior to IAI monotherapy in terms of disease-stabilizing efficacy, but with equivalent visual gain at 12 months.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Kikushima
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan. sakurada@yamanashi.ac.jp.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sakurada
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sugiyama
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Tanabe
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Atsuki
authors.initials: A
authors.lastname: Kume
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Iijima
mesh_terms: D000368:Aged; D002829:Choroid / Q000098:blood supply*; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011127:Polyps / Q000175:diagnosis / Q000188:drug therapy*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage* / Q000037:antagonists & inhibitors; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D017319:Photosensitizing Agents; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor
keywords: Aflibercept; Photodynamic therapy; Polypoidal choroidal vasculopathy; Retreatment-free period