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Two-year results of a treat-and-extend regimen with aflibercept for polypoidal choroidal vasculopathy

  • Retinal Disorders
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Abstract

Purpose

To evaluate the effects of aflibercept therapy using a treat-and-extend regimen on treatment-naïve polypoidal choroidal vasculopathy (PCV).

Methods

In a retrospective interventional case series of 58 eyes of 58 patients with PCV, we assessed best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CCT), and number of injections for 2 years. Polypoidal lesions were also evaluated before treatment and after the loading phase by indocyanine green angiography.

Results

BCVA significantly improved after the loading phase and was maintained in the maintenance phase. CMT and CCT significantly reduced after the loading phase and were maintained throughout the follow-up period. The number of injections averaged 7.72 in the first year and 4.67 in the second year. The average number of polypoidal lesions per patient was 2.43 before treatment. In 32 patients (55.2%), polypoidal lesions regressed completely after the loading phase; these patients also needed significantly fewer injections compared to other patients. CCT at baseline was positively correlated with the decreased amount of CCT after 2 years and negatively correlated with the number of injections for 2 years.

Conclusions

Treat-and-extend intravitreal therapy with aflibercept may be effective for improving BCVA and exudative change in eyes with PCV. The regression of polypoidal lesions after the loading phase and thicker choroid at baseline might lead to fewer total number of intravitreal injections of aflibercept.

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Acknowledgements

No funding was received for this research. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. Informed consent was obtained from all individual participants included in the study. Persons involved in the design and conduct of the study (H.M., M.M.); collection of the data (H.M., M.M., K.M.); management (H.M.); analysis (H.M., M.M.); interpretation (H.M.); preparation of article (H.M.); review and approval of the manuscript (M.M., K.M., H.A.).

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Authors and Affiliations

  1. Department of Ophthalmology, Gunma University, School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Masahiro Morimoto, Hidetaka Matsumoto, Kensuke Mimura & Hideo Akiyama

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  1. Masahiro Morimoto
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  2. Hidetaka Matsumoto
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Correspondence to Hidetaka Matsumoto.

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Morimoto, M., Matsumoto, H., Mimura, K. et al. Two-year results of a treat-and-extend regimen with aflibercept for polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol 255, 1891–1897 (2017). https://doi.org/10.1007/s00417-017-3718-6

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