gms | German Medical Science

Background: The optimal treatment for polypoidal choroidal vasculopathy (PCV) is still controversial. The current evidence suggests the superiority of anti-vascular endothelial growth factor therapy with regard to vision but some investigators recommend photodynamic therapy because it efficiently induces polyp regression. In the present study, we investigated the effect of aflibercept on visual gain and polyp regression rate in PCV patients.

Methods: We prospectively recruited 46 patients with typical age-related macular degeneration (tAMD) and 42 patients with PCV. They underwent three monthly injections followed by bimonthly injections of aflibercept. Visual acuity was measured with Landolt C chart and converted to logarithm of minimum angle of resolution (logMAR). Central retinal thickness was measured with optical coherence tomography. These parameters were compared between tAMD and PCV patients. In addition, we investigated the polyp regression rate in PCV patients.

Results: After the 12 months treatment, logMAR significantly improved in both groups (0.44 ± 0.08 to 0.32 ± 0.09, P < 0.001 in tAMD and 0.27 ± 0.05 to 0.08 ± 0.04, P < 0.001 in PCV). Central retinal thickness also showed improvement (325.4 ± 29.7 to 185.5 ± 19.8 µm, P < 0.001 in tAMD and 322.6 ± 21.5 to 156.3 ± 9.1µm, P < 0.001 in PCV) There was no difference in visual gain or the reduction in retinal thickness between the two groups (P = 0.426 and P = 0.116, respectively). Follow-up angiography was done in 39 patients with PCV and 27 of them (69.2%) showed regression of polyps.

Conclusions: Periodical injections of aflibercept is effective in PCV as well as in tAMD in terms of vision and the treatment efficiently induces polyp regression.