Purpose: To investigate the changes in subfoveal thickness after switching to intravitreal aflibercept injection for polypoidal choroidal vasculopathy (PCV).
Methods: We retrospectively reviewed 66 eyes of 65 PCV patients (mean age 75.7 years) which were refractory to ranibizumab. The choroidal thickness was measured by optical coherence tomography (OCT) using an enhanced depth imaging technique. Intravitreal aflibercept (2 mg/0.05 ml) was administered with three consecutive monthly injections as a loading dose, followed by further injections bimonthly (every two months).
Results: The mean subfoveal choroidal thickness significantly decreased from 203 μm at baseline to 171 μm at month 6 (P < 0.0001). The mean logMAR best-corrected visual acuity levels significantly improved from 0.40 at baseline to 0.33 at 6 months (P < 0.001). The central retinal thickness significantly decreased from 249 μm at baseline to 161 μm at 6 months (P < 0.0001). At month 6, 41 (62.1%) eyes had dry macula by OCT. Of 46 eyes with polypoidal lesions at baseline, complete regression of polypoidal lesions was achieved in 26 (56.5%) eyes at 3 months.
Conclusions: The choroidal thickness in PCV eyes significantly decreased after switching to intravitreal aflibercept injection. Aflibercept may help prevent choroidal neovascularization near or under the retinal pigment epithelium, which might help achieve greater occlusion of polypoidal lesions compared with ranibizumab.
Keywords: Aflibercept; Choroidal thickness; Polypoidal choroidal vasculopathy; Ranibizumab; Vascular endothelial growth factor.