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Updated: Apr 7, 2026
Author Spotlight: Overcoming Anti-VEGF Resistance Through Advanced Vascular Morphology Assessment in Choroidal Neovascularization
Published on: August 11, 2023
Anti-vascular endothelial growth factor monotherapy for polypoidal choroidal vasculopathy with polyps resembling
1Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
Purpose:
The objective of this study was to investigate the 2-year outcomes of treatment with anti-vascular endothelial growth factor (VEGF) in patients with polypoidal choroidal vasculopathy (PCV) with polyps resembling grape clusters.
Methods:
Twenty eyes in 20 patients were included. All patients initially received three consecutive anti-VEGF injections, followed by an as-needed re-injection schedule. Patients were followed regularly at 1- to 3-month intervals. The primary outcome was change in best-corrected visual acuity (BCVA).
Results:
The mean number of injections administered over the course of 24 months was 12.50 ± 2.77 (range, 9-18). The logarithm of the minimum angle of resolution (logMAR) BCVA improved from 0.61 ± 0.28 to 0.42 ± 0.27 at 12 months (P = 0.015), and 0.44 ± 0.31 at 24 months (P = 0.056). At 24 months, BCVA had improved in 6 (30.0 %) eyes by 0.3 logMAR or more, was stable in 11 (55.0 %) eyes, and had decreased in 3 (15.0 %) eyes. Complete absorption of fluid was achieved with anti-VEGF treatment in 18 (90 %) eyes at least once during the 2-year follow-up period, and 10 (50 %) eyes revealed a dry macula at 24 months. Two eyes (10.0 %) received rescue photodynamic therapy because subfoveal fluid persisted despite six and seven consecutive anti-VEGF injections. Of 18 eyes treated only with anti-VEGF agents, 3 (16.7 %) revealed partial resolution of the polypoidal lesions at 24 months.
Conclusions:
A treatment regimen with anti-VEGF effectively improved or maintained visual acuity over a 24-month period in patients with PCV with clusters of grape-like polyps, and required frequent injections, comparable to typical choroidal neovascularization in age-related macular degeneration.
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