J Korean Ophthalmol Soc.  2018 Mar;59(3):238-245. 10.3341/jkos.2018.59.3.238.

Long-term Treatment Outcome of Intravitreal Aflibercept Monotherapy for Polypoidal Choroidal Vasculopathy

• Kim YJ
• Han SY
• Kim JW
• Kim CG
• Lee DW
• Kim JH

• KMID: 2406958
• DOI: http://doi.org/10.3341/jkos.2018.59.3.238

Abstract

PURPOSE
To evaluate long-term treatment outcomes of intravitreal aflibercept monotherapy for polypoidal choroidal vasculopathy (PCV).
METHODS
A retrospective review of medical records was performed with 46 patients who were diagnosed with PCV and treated with aflibercept monotherapy for 24 months. Best-corrected visual acuity (BCVA) values measured at diagnosis, 3 months, 12 months, and 24 months were compared. Baseline morphological factors associated with the 24 month BCVA were additionally investigated.
RESULTS
The mean age of the patients was 65.8 ± 7.9 years. The patients were treated with a mean of 7.0 ± 2.3 aflibercept injections. The mean logarithm of the minimal angle of resolution (logMAR) BCVA at diagnosis, 3 months, 12 months, and 24 months was 0.56 ± 0.40, 0.36 ± 0.36, 0.45 ± 0.42, and 0.52 ± 0.47, respectively. When compared with baseline values, the BCVA was significantly improved at 3 months (p < 0.001) and 12 months (p = 0.022). However, the value at 24 months was not significantly different (p = 1.000). The BCVA was improved or maintained in 35 eyes (76.1%). Extrafoveal polypoidal lesions were associated with a better 24 month visual outcome than subfoveal/juxtafoveal lesions.
CONCLUSIONS
Aflibercept monotherapy was found to be an effective method to maintain or improve long-term visual acuity in PCV patients. The location of polypoidal lesions was a predictive factor for long-term visual outcomes.

Keyword

Aflibercept; Age-related macular degeneration; Choroidal neovascularization; Long-term; Polypoidal choroidal vasculopathy

MeSH Terms

Choroid*
Choroidal Neovascularization
Diagnosis
Humans
Macular Degeneration
Medical Records
Methods
Retrospective Studies
Treatment Outcome*
Visual Acuity

Figure

• 

  Figure 1. A representative case of polypoidal choroidal vasculopathy treated with intravitreal aflibercept monotherapy. At diagnosis (A-C), the decimal best-corrected visual acuity (BCVA) was 0.4. Subretinal fluid was resolved after 3 monthly aflibercept injections (D). The patient was treated with 9 aflibercept injections during the 24 months follow-up period. At 24 months (E), The BCVA was measured as 0.5. (A) Fluorescein angiography. (B) Indocyanine green angiography. (C-E) Optical coherence tomography images.

• 

  Figure 2. Graphs showing functional and anatomical outcomes. Changes in the logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) (A) and central foveal thickness (B) in the included patients (n = 46). M = months.

• 

  Figure 3. Proportion of patients when stratified into best-corrected visual acuity (decimal) (n = 46). At 24 months, 76.1% show visual acuity better than 0.1. M = months.

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