J Korean Ophthalmol Soc.  2015 Nov;56(11):1728-1735. 10.3341/jkos.2015.56.11.1728.

Short-Term Efficacy of Intravitreal Aflibercept for Polypoidal Choroidal Vasculopathy

• Yang H
• Jeon HM
• Kim SW
• Yoon HS
• Choae WS

• KMID: 2214181
• DOI: http://doi.org/10.3341/jkos.2015.56.11.1728

Abstract

PURPOSE
To evaluate the short-term effect of intravitreal aflibercept (Eylea(R); Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA and Bayer, Basel, Switzerland) on the visual outcomes and retinal anatomic changes of patients with polypoidal choroidal vasculopathy (PCV).
METHODS
Intravitreal Eylea(R) was injected into 16 eyes of 16 patients with PCV in this retrospective case study. After therapy, the patients were followed up for over 3 months. Changes in best-corrected visual acuity (BCVA) and central foveal thickness (CFT) using optical coherence tomography (OCT) and abnormal vasculature on indocyanine green angiography (ICGA) were evaluated.
RESULTS
The mean log MAR BCVA was 0.75 +/- 0.60 at baseline, 0.74 +/- 0.60 and 0.71 +/- 0.63 at 1 and 2 months, respectively (p > 0.05) and 0.57 +/- 0.53 at 3 months (p < 0.05) after treatment. The mean CFT was 379 +/- 130 microm at baseline, 281 +/- 92 microm, 247 +/- 54 microm, and 231 +/- 51 microm at 1, 2, and 3 months, respectively, after treatment (p < 0.05). Complete resolution was 43%, 55%, and 50% at 1, 2, and 3 months, respectively in pigment epithelial detachment (PED), 67%, 83%, and 92% at 1, 2, and 3 months, respectively in subretinal fluid (SRF) and 33%, 60%, and 60% at 1, 2, and 3 months, respectively in intraretinal fluid (IRF) using OCT. The polypoidal lesions in ICGA decreased in 12 of 14 eyes (86%).
CONCLUSIONS
Intravitreal injection of Eylea(R) with PCV reduced CFT due to decreased retinal PED, SRF, IRF and occluded effectively the polypoidal lesion leaking. Compared with baseline, mean BCVA at the 3-month follow-up was significantly improved.

Keyword

Aflibercept; Intravitreal injection; Polypoidal choroidal vasculopathy

MeSH Terms

Angiography
Choroid*
Follow-Up Studies
Humans
Indocyanine Green
Intravitreal Injections
Retinaldehyde
Retrospective Studies
Subretinal Fluid
Tomography, Optical Coherence
Visual Acuity
Indocyanine Green
Retinaldehyde

Figure

• 

  Figure 1. Change in logarithm of the minimum angle of reso-lution (log MAR), best-corrected visual acuity with time (months). Decrease at 1, 2, and 3 months was observed. A sig-nificant decrease was found at 3 months ( p < 0.05). Case 8, 11 were loss to FU after 1 month. FU = follow-up.

• 

  Figure 2. Change in percentage (%), in proportion of more than 0.2 log MAR with time (months). Increase in proportion of gain more than 0.2 log MAR, decrease in proportion of loss more than 0.2 log MAR with time was observed. log MAR = logarithm of the minimum angle of resolution.

• 

  Figure 3. Change in CFT (μ m) with time (months). A sig-nificant decrease was found at 1, 2, and 3months ( p < 0.05). Case 8, 11 were loss to FU after 1 month. CFT = central fo-veal thickness; FU = follow-up.

• 

  Figure 4. Case No. 5 (A) Baseline fundus photograph shows hard exudates, pigmentations around macula. (B) Baseline horizontal OCT image and (C) vertical OCT image shows protruding polyps and macular edema. (D-F) One month after the third injection, PED, SRF was completely resolved. OCT = optical coherence tomography; PED = pigment epithelial detachment; SRF= sub-retinal fluid.

• 

  Figure 5. Case No. 5 (A) Baseline ICGA shows polypoidal dilatation of choroidal vessels and branching vascular network. (B) One month after the third injection, polyps are resolved. But branching vascular network remains. ICGA = indocyanine green angiography.

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