One-year outcome of combination therapy with intravitreal aflibercept and verteporfin photodynamic therapy for polypoidal choroidal vasculopathy

Graefes Arch Clin Exp Ophthalmol. 2017 Mar;255(3):541-548. doi: 10.1007/s00417-016-3500-1. Epub 2016 Sep 30.

Abstract

Purpose: The purpose of the study was to evaluate the 1-year visual and anatomical outcomes of combination therapy with intravitreal aflibercept (IVA) and verteporfin photodynamic therapy (vPDT) for polypoidal choroidal vasculopathy (PCV), and to determine the predictors of a good visual outcome.

Methods: This was a prospective case-series study. Twenty eyes from 20 treatment-naïve PCV patients were treated with combination therapy with IVA and vPDT. Best-corrected visual acuity (BCVA) and morphological parameters including polypoidal lesions in indocyanine green angiography (ICGA) were evaluated over 12 months of follow-up.

Results: The mean logMAR BCVA was significantly improved from 0.30 at baseline to 0.20 at 3 months and 0.18 at 12 months. The mean central retinal thickness was also significantly improved at 3 months and at 12 months. In ICGA, complete regression of polypoidal lesions was found in 14 out of 20 eyes (70 %) at 3 months and in 14 out of 18 eyes (78 %) at 12 months although no ICGA were done on two eyes. In the multivariate logistic regression analyses, the baseline greatest linear dimension was found as a significant predictive factor for good visual improvement (≧0.3 LogMAR units improvement from baseline) at 12 months.

Conclusion: In this study, combination therapy with IVA and vPDT gave visual and anatomical improvements to treatment-naïve PCV patients over 12 months of follow-up period.

Keywords: Aflibercept; Combination therapy; One-year outcome; Polypoidal choroidal vasculopathy; Polypoidal lesion; Verteporfin photodynamic therapy.

MeSH terms

  • Aged
  • Choroid / blood supply*
  • Choroid / pathology
  • Choroid Diseases / diagnosis
  • Choroid Diseases / drug therapy*
  • Drug Therapy, Combination
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use
  • Polyps / diagnosis
  • Polyps / drug therapy*
  • Porphyrins / therapeutic use*
  • Prospective Studies
  • Receptors, Vascular Endothelial Growth Factor / administration & dosage*
  • Receptors, Vascular Endothelial Growth Factor / antagonists & inhibitors
  • Recombinant Fusion Proteins / administration & dosage*
  • Time Factors
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Verteporfin
  • Visual Acuity*

Substances

  • Photosensitizing Agents
  • Porphyrins
  • Recombinant Fusion Proteins
  • Verteporfin
  • aflibercept
  • Receptors, Vascular Endothelial Growth Factor