J Korean Ophthalmol Soc.  2016 Oct;57(10):1577-1585. 10.3341/jkos.2016.57.10.1577.

Analysis of Efficacy of Intravitreal Aflibercept According to Subfoveal Choroidal Thickness in Polypoidal Choroidal Vasculopathy

• Lee D
• Jeong S
• Moon J
• Lee J
• Sagong M

• KMID: 2355413
• DOI: http://doi.org/10.3341/jkos.2016.57.10.1577

Abstract

PURPOSE
To evaluate the effect of intravitreal aflibercept according to subfoveal choroidal thickness in patients with polypoidal choroidal vasculopathy (PCV).
METHODS
We retrospectively analyzed the medical records of 60 eyes from 60 patients with PCV treated with intravitreal aflibercept. The patients were followed for at least 6 months after the first injection. Using software, subfoveal choroidal thickness was manually measured as the distance from the hyper-reflective line of Bruch's membrane to the chorioscleral interface on optical coherence tomography. The patients were divided into three groups based on subfoveal choroidal thickness. Visual acuity, subfoveal choroidal thickness, central macular thickness and largest pigment epithelial detachment (PED) height, polyp regression rate, and dry macula rate were evaluated to analyze the anatomical and functional outcomes.
RESULTS
Baseline mean subfoveal choroidal thickness were 178.50 ± 28.42 µm in the thin group (14 eyes, 23.3%), 287.03 ± 43.58 µm in the medium group (33 eyes, 55.0%), and 379.77 ± 17.09 µm in the thick group (13 eyes, 21.7%). Baseline age, sex, visual acuity, central macular thickness, and the largest PED height did not differ significantly among the three subgroups. Only the thin group showed significant improvement of visual acuity at 6 months (p = 0.005). Subfoveal choroidal thickness, central macular thickness, and largest PED height were significantly decreased after treatment in all subgroups and did not differ among the subgroups. Compared with the other groups, the thin subfoveal choroidal thickness group showed higher polyp regression rate at 3 months and higher dry macula rate at 6 months (p = 0.013 and p = 0.004, respectively).
CONCLUSIONS
Intravitreal aflibercept injection was effective for the treatment of PCV, and thin subfoveal choroidal thickness was associated with better anatomical and functional outcomes.

Keyword

Aflibercept; Choroidal thickness; Polypoidal choroidal vasculopathy

MeSH Terms

Bruch Membrane
Choroid*
Humans
Medical Records
Polyps
Retrospective Studies
Tomography, Optical Coherence
Visual Acuity

Figure

• 

  Figure 1. Choroidal thickness was measured manually using a caliper that is provided in the optical coherence tomography device. The choroidal thickness (yellow arrow) was defined as the vertical distance between Bruch's membrane and the chorioscleral interface. (A) Thick choroidal thickness. (B) Thin choroidal thickness.

• 

  Figure 2. Subtype comparison of changes in best corrected visual acuity (log MAR) after intravitreal aflibercept injection. Thin group patients had statistically significant improvement of best corrected visual acuity at 3 months and 6 months compared to the baseline (3 months p = 0.008, 6 months p = 0.005, paired t-test). There was no statistically significant improvement in medium group and thick group. VA = visual acuity.

• 

  Figure 3. Subtype comparison of changes in subfoveal choroidal thickness (μ m) after intravitreal aflibercept injection. Choroidal thickness of all each group significantly decreased at 3 months and 6 months compared to the baseline. No stat-istical differences were shown among 3 groups for 6 months.

• 

  Figure 4. Subtype comparison of complete polyp regression rate at 3 months after 1st intravitreal aflibercept injection. The thin subfoveal choroidal thickness group showed higher complete polyp regression rate at 3 months.

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  Figure 5. Subtype comparison of anatomical outcomes using dry macula rate at 6 months after 1st intravitreal aflibercept injection. The thin subfoveal choroidal thickness group showed higher dry macula rate at 6 months.

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