Short-term efficacy of intravitreal aflibercept for patients with treatment-naïve polypoidal choroidal vasculopathy

To evaluate the short-term efficacy of aflibercept monotherapy for patients with treatment-naïve polypoidal choroidal vasculopathy (PCV).

Prospective, consecutive case series.

Thirty-three consecutive eyes of 33 symptomatic PCV patients (17 men, 16 women, mean age 75 ± 8.7 years), not treated previously, received an intravitreal injection of 2.0 mg of aflibercept monthly for 3 months. Changes in best-corrected visual acuity (BCVA), optical coherence tomography (OCT) findings, and indocyanine green angiography (ICGA) findings 3 months after initial injection were evaluated.

Compared with baseline, mean BCVA at 3-month visit significantly improved (0.40 ± 0.34 vs 0.22 ± 0.20 log minimum angle of resolution [logMAR] unit, P < 12 0.001). Eight eyes (24 %) showed improvement in BCVA ≥ 0.3 logMAR unit, and no eyes (0 %) showed a decrease in BCVA of ≥ 0.3 logMAR unit. Mean foveal thickness improved significantly (348 ± 184 μm at baseline vs 194 ± 32 μm at 3-month visit, P < 15 0.001). At 3-month visit, 31 eyes (97 %) achieved dry macula evaluated on OCT. Polypoidal lesions disappeared completely on ICGA in 16 eyes (48 %), and the number and/or the size of polypoidal lesions decreased in nine eyes (27 %). The remaining eight eyes (24 %) had unchanged polypoidal lesions. A branching vascular network remained and was unchanged in diameter in all 27 eyes in which it was detected at baseline.

Intravitreal aflibercept was well-tolerated in patients with treatment-naïve PCV over the short-term.