Aflibercept therapy for polypoidal choroidal vasculopathy: short-term results of a multicentre study

To investigate short-term outcomes of intravitreal aflibercept injections (IAIs) for polypoidal choroidal vasculopathy (PCV).

91 eyes of 88 consecutive patients with treatment-naive PCV examined at three university hospitals received IAI monthly for 3 months. One month after the third IAI, changes in best-corrected visual acuity (BCVA) and macular morphology were retrospectively evaluated. Additionally, possible baseline characteristics predictive of persistent retinal fluid were analysed.

The mean BCVA (logarithm of the minimum angle of resolution units) of the 91 eyes improved from 0.31 at baseline to 0.21 at 3 months (p<0.0001). The mean central retinal thickness and mean subfoveal choroidal thickness decreased from 323 μm and 270 μm at baseline to 185 μm and 232 μm at 3 months, respectively (p<0.0001 for both). Seventy-three eyes (80.2%) achieved a dry macula defined as absence of retinal fluid. Presence of the baseline characteristics of subretinal haemorrhage and greater size of the largest polyp were significantly associated with inability to achieve a dry macula (p=0.008 and 0.03, respectively). However, this association was not found on multivariate logistic regression. Of the 90 eyes that underwent indocyanine green angiography at 3 months, 43 eyes (47.8%) showed complete and 28 eyes (31.1%) showed partial resolution of polyps. Twenty-four eyes (24.4%) also showed partial regression of branching choroidal vascular networks.

IAIs for the treatment of a large number of PCV eyes were found to improve both visual acuity and macular morphology over the short term.