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Prognostic factors after aflibercept therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To determine factors predictive of visual outcomes in eyes treated with intravitreal aflibercept injections (IAIs) for typical neovascular age-related macular degeneration (AMD) or polypoidal choroidal vasculopathy (PCV).

Study design

Retrospective, multicenter, institutional, consecutive, interventional case series.

Methods

One hundred nine eyes (107 patients) with treatment-naïve neovascular AMD at 3 university hospitals were studied. After a loading phase of 3 monthly 2.0-mg IAIs, injections were administered every 2 months. The baseline clinical characteristics were investigated in relation to the 12-month visual outcomes. Changes in the mean best-corrected visual acuity (BCVA) were measured at 12 months after initiation of aflibercept therapy.

Results

Forty-five eyes (41.3%) had typical neovascular AMD, and 64 eyes (58.7%) had PCV. The changes in the mean BCVA at 12 months compared with baseline did not differ significantly (P = .737) between the 2 groups. Stepwise analysis showed that larger gains in the BCVA at 12 months were associated with poor BCVA (P < .001), no pigment epithelial detachment (P = .004), and subretinal fluid (P = .039) at baseline in eyes with typical neovascular AMD; larger gains in the BCVA were associated with poorer BCVA (P < .001), presence of choroidal vascular hyperpermeability (CVH) (P = .013), and subretinal fluid (P = .044) at baseline in eyes with PCV.

Conclusions

Although poorer BCVA and the presence of subretinal fluid predicted larger gains in BCVA in both subtypes treated with aflibercept, eyes with typical neovascular AMD had greater improvement if no pigment epithelial detachment was present, while eyes with PCV had greater improvement if CVH was present.

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Authors and Affiliations

  1. Department of Ophthalmology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan

    Masashi Ogasawara, Kanako Itagaki, Masaaki Saito & Tetsuju Sekiryu

  2. Department of Ophthalmology, Tokyo Women’s Medical University, Tokyo, Japan

    Hideki Koizumi, Ichiro Maruko & Tomohiro Iida

  3. Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan

    Akiko Yamamoto & Annabelle A. Okada

Authors
  1. Masashi Ogasawara
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  2. Hideki Koizumi
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  3. Akiko Yamamoto
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  4. Kanako Itagaki
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  5. Masaaki Saito
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  6. Ichiro Maruko
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  7. Annabelle A. Okada
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  8. Tomohiro Iida
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  9. Tetsuju Sekiryu
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Corresponding author

Correspondence to Tetsuju Sekiryu.

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Conflicts of interest

M. Ogasawara, None; Hideki Koizumi, Grant (Novartis Pharma), Moderator fees (Alcon, Bausch & Lomb, Bayer, Canon, HOYA, Kowa, NIDEK, Novartis Pharma, Santen Pharmaceutical, Senju Pharmaceutical, Topcon, Wakamoto Pharmaceutical); A. Yamamoto, Lecture fees (Bayer, Novartis Pharma, Pfizer, Santen Pharmaceutical); K. Itagaki, None; M. Saito, Grant (Bayer, Novartis Pharma, Santen Pharmaceutical), Moderator fees (Alcon, AMO, Bayer, HOYA, Novartis Pharma, Santen Pharmaceutical, Senju Pharmaceutical); I. Maruko, Moderator fees (Alcon, Bayer, NIDEK, Novartis Pharma, Santen Pharmaceutical, Topcon); A. A. Okada, Grant (Bayer, Mitsubishi Tanabe Pharma), Advisory board fee (Bayer), Consultant fee (XOMA), Lecture fees (Bayer, Novartis Pharma, Santen Pharmaceutical), Research funds (Bayer, Mitsubishi Tanabe Pharma); T. Iida, Grant (Bayer, Nidek, Novartis Pharma, Santen Pharmaceutical), Lecture fees (Bayer, Novartis Pharma, Santen Pharmaceutical); T. Sekiryu, None.

Additional information

Corresponding author: Tetsuju Sekiryu

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Cite this article

Ogasawara, M., Koizumi, H., Yamamoto, A. et al. Prognostic factors after aflibercept therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy. Jpn J Ophthalmol 62, 584–591 (2018). https://doi.org/10.1007/s10384-018-0605-6

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  • DOI: https://doi.org/10.1007/s10384-018-0605-6

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