Short-term efficacy of intravitreal aflibercept depending on angiographic classification of polypoidal choroidal vasculopathy.
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).



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.



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).



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.



NCT02597855, Results.
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.
Seongyong
0000-0001-9175-9642
S
Jeong
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.
Min
M
Sagong
D000368:Aged; D020256:Choroidal Neovascularization / Q000145:classification* / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000145:classification* / Q000175:diagnosis / Q000188:drug therapy*; D011446:Prospective Studies; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor
Macula; Neovascularisation; Retina; Treatment Medical