One-year Results of Aflibercept Treatment for Polypoidal Choroidal Vasculopathy with Good Visual Acuity

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the one-year efficacy of intravitreal aflibercept injection in polypoidal choroidal vasculopathy (PCV)with best-corrected visual acuity (BCVA) of 20 / 40 or better. Methods: This was a multicenter retrospective study. The medical records of patients diagnosed with treatment-naïve PCVwere retrospectively reviewed. Patients with an initial BCVA of 20 / 40 or better and who had undergone intravitreal afliberceptinjection were included. Patients were treated with three consecutive monthly injections, followed by pro re nata regimenaccording to the clinician’s discretion at variable interval visits. The proportions of eyes for which BCVA was maintained(≤ 0.2 logarithm of the minimum angle of resolution change) or improved at 12 months were evaluated. The changes ofBCVA, central subfield macular thickness (CSMT), pigment epithelial detachment, and subretinal fluid also were assessed. Results: A total of 86 eyes were included. The mean number of injections for 12 months of treatment was 5.4 ± 1.7. BCVAwas maintained or improved in 94.2% (81 / 86) of cases. Mean BCVA (logarithm of the minimum angle of resolution)had changed from the baseline (0.23 ± 0.09) at 3 months (0.21 ± 0.14), 6 months (0.24 ± 0.22), and 12 months (0.20± 0.18), but with no statistical significance. CSMT had improved significantly from the baseline (336.1 ± 97.3 μm) at 3months (223.6 ± 47.22 μm), 6 months (239.6 ± 64.2 μm), and 12 months (223.8 ± 47.9 μm). Pigment epithelial detachmentwas observed in 93% of cases at the baseline, 72.1% at 3 months, and 69.8% at 12 months, showing a significantdecrease at all observation points. Subretinal fluid was observed in 91.9% of cases at the baseline, 20.9% at 3 months,and 29.1% at 12 months, showing a significant decrease at all observation points. Conclusions: In cases of PCV with good visual acuity, intravitreal aflibercept injections decreased CSMT and were effectivein maintaining visual acuity.

목차 (Table of Contents)

• Materials and Methods Results Discussion Conflict of Interest References

참고문헌 (Reference)

1 박규형, "국내의 나이관련황반변성에 대한 기초역학조사" 대한안과학회 51 (51): 516-523, 2010

2 김예지, "결절맥락막혈관병증에서 유리체강 내 애플리버셉트 단독치료의 장기 결과" 대한안과학회 59 (59): 238-245, 2018

3 Mori R, "Treatment results at 1 year of ranibizumab therapy for polypoidal choroidal vasculopathy in eyes with good visual acuity" 57 : 365-371, 2013

4 Wong CW, "Three-year results of polypoidal choroidal vasculopathy treated with photodynamic therapy: retrospective study and systematic review" 35 : 1577-1593, 2015

5 Gu X, "Therapeutic effects of ranibizumab in patients with polypoidal choroidal vasculopathy" 19 : 153-, 2019

6 Akaza E, "Role of photodynamic therapy in polypoidal choroidal vasculopathy" 51 : 270-277, 2007

7 Brown DM, "Ranibizumab versus verteporfin for neovascular age-related macular degeneration" 355 : 1432-1444, 2006

8 Rosenfeld PJ, "Ranibizumab for neovascular age-related macular degeneration" 355 : 1419-1431, 2006

9 Uyama M, "Polypoidal choroidal vasculopathy: natural history" 133 : 639-648, 2002

10 Honda S, "Polypoidal choroidal vasculopathy: clinical features and genetic predisposition" 231 : 59-74, 2014

11 Kokame GT, "Polypoidal choroidal vasculopathy exudation and hemorrhage: results of monthly ranibizumab therapy at one year" 231 : 94-102, 2014

12 Lee WK, "Polypoidal choroidal vasculopathy" 41 : 2573-2584, 2000

13 Ciardella AP, "Polypoidal choroidal vasculopathy" 49 : 25-37, 2004

14 Chan WM, "Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy: one-year results of a prospective case series" 111 : 1576-1584, 2004

15 Nowak-Sliwinska P, "Photodynamic therapy for polypoidal choroidal vasculopathy" 37 : 182-199, 2013

16 Ho M, "Outcome of polypoidal choroidal vasculopathy at 1 year by combined therapy of photodynamic therapy with ranibizumab and predictive factors governing the outcome" 28 : 1469-1476, 2014

17 Oshima Y, "One-year outcomes following intravitreal aflibercept for polypoidal choroidal vasculopathy in Japanese patients: the APOLLO Study" 238 : 163-171, 2017

18 Kang HM, "Long-term visual outcome and prognostic factors after intravitreal ranibizumab injections for polypoidal choroidal vasculopathy" 156 : 652-660, 2013

19 Kato A, "Intravitreal ranibizumab for patients with neovascular age-related macular degeneration with good baseline visual acuity" 233 : 27-34, 2015

20 Saito M, "Intravitreal ranibizumab for exudative age-related macular degeneration with good baseline visual acuity" 32 : 1250-1259, 2012

21 Ogino K, "Intravitreal injection of ranibizumab for recovery of macular function in eyes with subfoveal polypoidal choroidal vasculopathy" 54 : 3771-3779, 2013

22 Sakamoto S, "Intravitreal aflibercept for exudative age-related macular degeneration with good visual acuity: 2-year results of a prospective study" 12 : 1137-1147, 2018

23 Cho HJ, "Intravitreal aflibercept and ranibizumab injections for polypoidal choroidal vasculopathy" 165 : 1-6, 2016

24 Zhao M, "Interleukin-1β level is increased in vitreous of patients with neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV)" 10 : e0125150-, 2015

25 Byeon SH, "Incidence and clinical patterns of polypoidal choroidal vasculopathy in Korean patients" 52 : 57-62, 2008

26 Uyama M, "Idiopathic polypoidal choroidal vasculopathy in Japanese patients" 117 : 1035-1042, 1999

27 Yannuzzi LA, "Idiopathic polypoidal choroidal vasculopathy (IPCV). 1990" 32 (32): 1-8, 2012

28 Chen H, "Genetic associations in polypoidal choroidal vasculopathy: a systematic review and meta-analysis" 18 : 816-829, 2012

29 Hikichi T, "Factors predictive of outcomes 1 year after 3 monthly ranibizumab injections and as-needed reinjections for polypoidal choroidal vasculopathy in Japanese patients" 33 : 1949-1958, 2013

30 Matsuoka M, "Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathy" 88 : 809-815, 2004

31 Lee JE, "Efficacy of fixed-dosing aflibercept for treating polypoidal choroidal vasculopathy:1-year results of the VAULT study" 255 : 493-502, 2017

32 Koh A, "Efficacy and safety of ranibizumab with or without verteporfin photodynamic therapy for polypoidal choroidal vasculopathy: a randomized clinical trial" 135 : 1206-1213, 2017

33 Matsumiya W, "Effectiveness of intravitreal ranibizumab in exudative age-related macular degeneration (AMD): comparison between typical neovascular AMD and polypoidal choroidal vasculopathy over a 1 year follow-up" 13 : 10-, 2013

34 Koh A, "EVEREST study: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy" 32 : 1453-1464, 2012

35 Oishi A, "Comparison of the effect of ranibizumab and verteporfin for polypoidal choroidal vasculopathy: 12-month LAPTOP study results" 156 : 644-651, 2013

36 Papadopoulos N, "Binding and neutralization of vascular endothelial growth factor (VEGF)and related ligands by VEGF Trap, ranibizumab and bevacizumab" 15 : 171-185, 2012

37 Minami S, "Benefits of aflibercept treatment for age-related macular degeneration patients with good best-corrected visual acuity at baseline" 8 : 58-, 2018

38 Sasaki S, "Associations of IL23 with polypoidal choroidal vasculopathy" 53 : 3424-3430, 2012

39 Tong JP, "Aqueous humor levels of vascular endothelial growth factor and pigment epithelium-derived factor in polypoidal choroidal vasculopathy and choroidal neovascularization" 141 : 456-462, 2006

40 Bae K, "Angiographic subtypes of neovascular age-related macular degeneration in Korean: a new diagnostic challenge" 9 : 9701-, 2019

41 Yoshimura N, "Age-related macular degeneration in the Japanese" 120 : 163-188, 2016

42 Song SJ, "Age-related macular degeneration in a screened South Korean population: prevalence, risk factors, and subtypes" 16 : 304-310, 2009

43 Lo Giudice G, "Acute visual loss and chorioretinal infarction after photodynamic therapy combined with intravitreal triamcinolone" 18 : 652-655, 2008