Recurrence and visual prognostic factors of polypoidal choroidal vasculopathy: 5-year results

Kim, Joo Young; Son, Woo Young; Kim, Rae Young; Kim, Min-Ju; Park, Young Gun

doi:10.1038/s41598-021-00904-4

Cited by 4 publications

(7 citation statements)

References 30 publications

(31 reference statements)

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“…However, no differences in characteristics were noted between the responder and non-responder groups. In addition, although previous studies have shown that imaging features-including choroidal vascular hyperpermeability, presence of polyp clusters, greater linear dimension of the lesion, largest polyp diameter, and choroidal thickness-can influence the treatment outcomes [22][23][24], there was no significant difference in these features between the responder and the non-responder group. However, we postulate that these results were partially induced by the small sample size in this study.…”

Section: Discussionmentioning

confidence: 78%

Short-Term Outcomes of Switching to Ranibizumab in Polypoidal Choroidal Vasculopathy Resistant to Aflibercept Therapy

Jeon

Kim

et al. 2021

JCM

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Background: To evaluate the short-term outcomes of switching to ranibizumab in aflibercept-resistant polypoidal choroidal vasculopathy (PCV). Methods: This retrospective study included 18 eyes diagnosed with aflibercept-resistant PCV. All patients were treated with two to four consecutive ranibizumab injections at 4–5-week intervals. The best-corrected visual acuity (BCVA), and central retinal thickness (CRT) values before and after switching to ranibizumab were compared. The proportion of eyes showing ≥100 µm decrease in retinal thickness and/or complete resolution of fluid after switching was identified. Results: The mean number of aflibercept injections before switching was 5.7 ± 3.3. After switching, a mean of 2.8 ± 0.6 consecutive ranibizumab injections was performed. The mean logarithm of minimal angle of resolution (logMAR) BCVA was 0.41 ± 0.26 (Snellen equivalents = 20/51) before switching, and 0.40 ± 0.30 (20/50) after switching (p = 0.574). The mean CRT was 422.2 ± 152.4 µm before switching, and 400.7 ± 182.0 µm after switching (p = 0.236). A decrease in CRT of ≥100 µm, and/or complete resolution of fluid was noted in three eyes (16.7%). Conclusions: Switching to ranibizumab in aflibercept-resistant polypoidal choroidal vasculopathy was not effective in most patients, suggesting the need for further investigation to seek more effective treatment options for this condition.

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Section: Discussionmentioning

confidence: 78%

Short-Term Outcomes of Switching to Ranibizumab in Polypoidal Choroidal Vasculopathy Resistant to Aflibercept Therapy

Jeon

Kim

et al. 2021

JCM

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“…Younger age at onset, higher choroidal vascularity index, and presence of CVH were related with low risk of recurrence. For those with recurrence, having large lesion, and cluster polypoidal lesions were found to be associated with worse final visual acuity 119…”

Section: Updates On Treatment Of Pcvmentioning

confidence: 91%

“…For those with recurrence, having large lesion, and cluster polypoidal lesions were found to be associated with worse final visual acuity. 119 RPE and Retina. In a retrospective series of patients with PCV treated with either ranibizumab or aflibercept in a PRN regimen and 24-month follow-up, 10.5% developed RPE atrophy.…”

Section: Specific Characteristicsmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy: Updates on Risk Factors, Diagnosis, and Treatments

Ruamviboonsuk

Cheung

Chainakul

et al. 2023

Asia-Pacific Journal of Ophthalmology

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There have been recent advances in basic research and clinical studies in polypoidal choroidal vasculopathy (PCV). A recent, large-scale, population-based study found systemic factors, such as male gender and smoking, were associated with PCV, and a recent systematic review reported plasma C-reactive protein, a systemic biomarker, was associated with PCV. Growing evidence points to an association between pachydrusen, recently proposed extracellular deposits associated with the thick choroid, and the risk of development of PCV. Many recent studies on diagnosis of PCV have focused on applying criteria from noninvasive multimodal retinal imaging without requirement of indocyanine green angiography. There have been attempts to develop deep learning models, a recent subset of artificial intelligence, for detecting PCV from different types of retinal imaging modality. Some of these deep learning models were found to have high performance when they were trained and tested on color retinal images with corresponding images from optical coherence tomography. The treatment of PCV is either a combination therapy using verteporfin photodynamic therapy and anti-vascular endothelial growth factor (VEGF), or anti-VEGF monotherapy, often used with a treat-and-extend regimen. New anti-VEGF agents may provide more durable treatment with similar efficacy, compared with existing anti-VEGF agents. It is not known if they can induce greater closure of polypoidal lesions, in which case, combination therapy may still be a mainstay. Recent evidence supports long-term follow-up of patients with PCV after treatment for early detection of recurrence, particularly in patients with incomplete closure of polypoidal lesions.

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“…Polypoidal choroidal vasculopathy (PCV) is a variant of neovascular AMD, characterized by aneurysmal dilatations at the end of a type 1 neovascularization [ 3 – 5 ]. While randomized controlled trials have reported visual improvement up to 2 years [ 6 – 9 ], there is a paucity of long-term outcome data [ 10 , 11 ]. The EVEREST II study compared the efficacy and safety of intravitreally administered ranibizumab (IVR) alone or in combination with photodynamic therapy (PDT) over a 2-year period.…”

Section: Introductionmentioning

confidence: 99%

Six-Year Outcomes in Subjects with Polypoidal Choroidal Vasculopathy in the EVEREST II Study

Teo,

Park,

Ngah

et al. 2024

Ophthalmol Ther

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Introduction The EVEREST II study previously reported that intravitreally administered ranibizumab (IVR) combined with photodynamic therapy (PDT) achieved superior visual gain and polypoidal lesion closure compared to IVR alone in patients with polypoidal choroidal vasculopathy (PCV). This follow-up study reports the long-term outcomes 6 years after initiation of the EVEREST II study. Methods This is a non-interventional cohort study of 90 patients with PCV from 16 international trial sites who originally completed the EVEREST II study. The long-term outcomes were assessed during a recall visit at about 6 years from commencement of EVEREST II. Results The monotherapy and combination groups contained 41 and 49 participants, respectively. The change in best-corrected visual acuity (BCVA) from baseline to year 6 was not different between the monotherapy and combination groups; − 7.4 ± 23.0 versus − 6.1 ± 22.4 letters, respectively. The combination group had greater central subfield thickness (CST) reduction compared to the monotherapy group at year 6 (− 179.9 vs − 74.2 µm, p = 0.011). Fewer eyes had subretinal fluid (SRF)/intraretinal fluid (IRF) in the combination versus monotherapy group at year 6 (35.4% vs 57.5%, p = 0.032). Factors associated with BCVA at year 6 include BCVA (year 2), CST (year 2), presence of SRF/IRF at year 2, and number of anti-VEGF treatments (years 2–6). Factors associated with presence of SRF/IRF at year 6 include combination arm (OR 0.45, p = 0.033), BCVA (year 2) (OR 1.53, p = 0.046), and presence of SRF/IRF (year 2) (OR 2.59, p = 0.042). Conclusion At 6 years following the EVEREST II study, one-third of participants still maintained good vision. As most participants continued to require treatment after exiting the initial trial, ongoing monitoring and re-treatment regardless of polypoidal lesion status are necessary in PCV. Trial Registration ClinicalTrials.gov identifier, NCT01846273.

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Recurrence and visual prognostic factors of polypoidal choroidal vasculopathy: 5-year results

Cited by 4 publications

References 30 publications

Short-Term Outcomes of Switching to Ranibizumab in Polypoidal Choroidal Vasculopathy Resistant to Aflibercept Therapy

Short-Term Outcomes of Switching to Ranibizumab in Polypoidal Choroidal Vasculopathy Resistant to Aflibercept Therapy

Polypoidal Choroidal Vasculopathy: Updates on Risk Factors, Diagnosis, and Treatments

Six-Year Outcomes in Subjects with Polypoidal Choroidal Vasculopathy in the EVEREST II Study

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