Aflibercept Treatment in Polypoidal Choroidal Vasculopathy: Results of a Prospective Study in a Caucasian Population

Abstract

Introduction: Polypoidal choroidal vasculopathy (PCV) is a choroidal pathology characterized by frequent occurrences of subretinal hemorrhages and resistance to monotherapies such as ranibizumab or bevacizumab intravitreal injections (IVT). The purpose of this study is to evaluate both the anatomical and functional efficacy of aflibercept IVT as a monotherapy in PCV in a Caucasian population. Methods: We conducted a prospective multicenter study in either treatment-naïve patients with PCV or PVC patients who had not been treated with anti-VEGF within the previous 3 months or with photodynamic therapy (PDT) within the previous 6 months. All patients had been treated with 3 initial monthly loading doses of aflibercept followed by a Q8 regimen for 28 weeks in total. All patients underwent a complete ophthalmic examination including the measurement of best-corrected visual acuity (BCVA) before each IVT and after 28 weeks as well as an optical coherent tomography (OCT) of the macula. At baseline and 28 weeks, the polypoidal dilations were analyzed with indocyanine green angiography. Results: Thirty-four eyes of 34 patients were included in this study. All patients were followed for 28 weeks and received 5 aflibercept IVT. The mean baseline BCVA was 55 letters. After 28 weeks, significant +13 letters in BCVA and a regression of exudative signs on OCT in all patients were observed. In 62% of the cases, polyp disappearance was observed on indocyanine green angiography. Discussion: In this study on a Caucasian population, we showed that aflibercept as a monotherapy provided both a significant visual gain and the regression of polypoidal dilations. Aflibercept use in monotherapy may contribute to reduce the hemorrhagic risk and atrophy linked to PDT.

Idiopathic polypoidal choroidal vasculopathy in Caucasians: The POLYON real-life study in 50 naive patients

“…In line with the literature, we reported a predominance of women, but with a higher mean age (73.9 ± 9.1 years). 1 This particularity of the Caucasian population has also been stressed by Wolff et al 6 and Agorogiannis et al 7 In our population, half of the patients showed associated signs of AMD. Therefore, this suggests a high proportion of type 1 PCV compatible with the Caucasian origin of our cohort.…”

“…5 At 2 years, the PLANET study did not find any difference in VA between the combined treatment (aflibercept-PDT) and aflibercept monotherapy. 4 In our study, VA appeared to have a worse evolution than that described in the PLANET study and in Wolff et al 6 study. This difference could be explained by several aspects: the characteristics of our Caucasian population (older, more patients with associated AMD), the therapeutic regimen without loading dose, and PRN protocol used in our study, involving a smaller number of IVIs.…”

Two-year results of a treat and extend regimen with aflibercept in Caucasian patients with aneurysmal type 1 neovascularization

“…A few reports have been performed in Caucasian with the aim of investigating the therapeutic approach of AT1. In the prospective multicenter study of Wolff et al 28 A total of 34 eyes were treated with a fixed-dosing aflibercept during 6 months. The results were a gain of 13 letters and a rate of polyp regression of 62%.…”

Modern aspects of polypoidal choroidal vasculopathy diagnosis and treatment

“…Одно из таких исследований -работа Wolff et al, направленная на оценку показателей эффективности афлиберцепта у 34 пациентов. К концу 6-го месяца терапии среднее улучшение зрения составило 13 букв по шкале ETDRS, при этом у 62 % пациентов отмечалась полная резорбция полипов [36]. Разумеется, для формулирования чётких выводов о применении афлиберцепта у пациентов с ПХВ в европеоидной популяции требуется более обширная доказательная база, однако подобные небольшие работы могут сформировать предварительное мнение о показателях эффективности препарата и в данной подгруппе пациентов.…”