Comparison between 1-year outcomes of aflibercept with and without photodynamic therapy for polypoidal choroidal vasculopathy: Retrospective observation study

Abstract

Polypoidal choroidal vasculopathy (PCV) is characterized by polyp-like choroidal neovascularization and a branching vascular network. Intravitreal aflibercept injection (IAI) or photodynamic therapy (PDT) is used for treatment. We retrospectively compared the 1-year outcomes of IAI monotherapy and its combination with initial PDT for PCV. Twelve eyes with naïve PCV received three IAIs and a single PDT after the first IAI and as needed injection (combination group); 11 eyes with naïve PCV received three IAIs and as needed injections (IAI group). Significant improvements in visual acuity after 2 months and in CRT after 1 month were maintained at 12 months in both groups (both P < 0.05); groups did not differ significantly at any time point. CCT significantly reduced after 3 and 12 months in the combination group (both P < 0.05) but not in the IAI group. A mean of 3.7 ± 0.9 and 5.6 ± 2.0 injections was administered to the combination and IAI groups, respectively (P = 0.013). Within a 1-year period, combination therapy was found to yield similar visual acuity and retinal structure improvements and maintenance as IAI monotherapy while requiring fewer IAIs.

Comparison of two-year outcomes after photodynamic therapy with ranibizumab or aflibercept for polypoidal choroidal vasculopathy

“…Intravitreal injection of anti-VEGF agents is expected to decrease the high intraocular concentration of VEGF, which causes exudation of both intraretinal and subretinal fluid. Combination therapy with PDT and intravitreal anti-VEGF agents has been demonstrated to reduce the incidence of PDT-related hemorrhagic complications relative to treatment with PDT alone 17 , and is also more effective for improving visual acuity 18 and reducing retreatment than intravitreal anti-VEGF-agent monotherapy in eyes with PCV 19 , 20 .…”

“…Another anti-VEGF agent, aflibercept, is a recombinant fusion protein that binds to VEGF-A, VEGF-B, and placental growth factors with a higher binding affinity than other available anti-VEGF agents, including ranibizumab and bevacizumab 24 . The one-year results that have been reported for PDT combined with intravitreal aflibercept (IVA) are favorable 19 , 20 , 25 .…”

Comparison of the Efficacy of Three Loading Doses of Intravitreal Injection of Conbercept with Injection Combined with PDT for the Treatment of PCV

“…Comparison of aflibercept monotherapy and aflibercept combination with PDT had been reported [17,18]. Takayama et al reported that aflibercept monotherapy achieved similar visual acuity improvements and anatomical recovering as compared to combination therapy [17]. Kikushima et al also reported that aflibercept monotherapy and combination therapy were equivalent in achieving visual gain after 12 months of treatment [18].…”

“…The structure of conbercept is similar with that of aflibercept. Comparison of aflibercept monotherapy and aflibercept combination with PDT had been reported [17,18]. Takayama et al reported that aflibercept monotherapy achieved similar visual acuity improvements and anatomical recovering as compared to combination therapy [17].…”

One-Year Outcome of Aflibercept and Photodynamic Therapy in a Caucasian Patient with Polypoidal Choroidal Vasculopathy Refractory to Ranibizumab and Photodynamic Therapy

“…A case series of 20 patients with PCV has shown that this combination provides visual and anatomic improvements over a 12-month follow-up period. A retrospective chart review comparing 1-year outcomes among 12 patients who received a loading dose of aflibercept (with [ n = 11] or without [ n = 12] PDT) followed by as needed injections has shown that although both treatments yielded similar visual and anatomic outcomes, patients receiving combination therapy required fewer injections [ 10 ]. Recently, the benefit of combined therapy with aflibercept 2.0 mg and PDT compared to aflibercept 2.0 mg monotherapy has been assessed in a randomised, double-masked, sham-controlled, phase 3b/4 study (PLANET study) conducted in 318 patients from 62 centres, mostly in Asia.…”