Comparison of the 1-year Outcomes of Conbercept Therapy between Two Different Angiographic Subtypes of Polypoidal Choroidal Vasculopathy

Abstract

Background:Polypoidal choroidal vasculopathy (PCV) is characterized by the presence of polyps with or without a branching vascular network and more prevalent among Asians. The aim of this study was to compare the outcomes of conbercept therapy between two different angiographic subtypes of PCV.Methods:Fifty-eight patients of PCV were classified into two phenotypes according to indocyanine green angiography (ICGA). In Type 1, both feeder and draining vessels are visible on ICGA and network vessels are numerous. In Type 2, neither feeder nor draining vessels are detectable, and the number of network vessels is small. The patients were treated with intravitreal conbercept (IVC) for 3 months. Additional IVC was given at subsequent monthly visits, if needed. The patients were followed up for 12 months, and changes in mean best-corrected visual acuity (BCVA), central retinal thickness (CRT), subretinal fluid (SRF) thickness, pigmented epithelial detachment (PED), hemorrhage, and number of polypoidal lesions were evaluated.Results:The mean BCVA in Type 2 PCV (15.92 ± 9.76 letters) achieved a significantly greater improvement than that in the Type 1 (14.10 ± 9.07 letters) at month 12 (t = 2.37, P < 0.01). Moreover, the mean CRT decrease was numerically greater in Type 2 (120.44 ± 73.81 μm) compared with Type 1 (106.48 ± 72.33 μm) at month 6 (t = 4.31, P < 0.01), and greater in Type 2 (130.21 ± 76.28 μm) compared with Type 1 (111.67 ± 79.57 μm) at month 9 (t = 1.87, P < 0.01). There was no significant difference between the two types for the decrease in SRF thickness, PED height, and regression of polyps from month 3 to 12 (t = 2.97, P > 0.05).Conclusion:Classification systems for PCV will show differences in presentation, natural history, or response to anti-vascular endothelial growth factor treatment and might, therefore, provide a new key to the choice of treatment for the disease.

CD11b and CD200 on Circulating Monocytes Differentiate Two Angiographic Subtypes of Polypoidal Choroidal Vasculopathy

“…12,14 Interestingly, recent reports of treatment outcomes suggest that PCVs with a strong presence of BVN respond better to anti-VEGF treatment than PCVs without or very faint BVNs. 18,19 These results suggest that there may be differences in the etiologic mechanisms between these angiographic subtypes. [20][21][22][23] Indeed, genetic studies have found differences in the genetic background when comparing patients with these different angiographic subtypes, and patients with PCV with a strong presence of BVN are more likely to have a genetic composition similar to that seen in patients with neovascular AMD.…”

“…We further categorized PCVs into subtypes based on ICGA presence of BVN: type 1, polypoidal lesions with visible feeder and draining vessels and strong presence of BVNs; or type 2, polypoidal lesions without clear visible feeder or draining vessels and without or faint BVNs. 18,19,[21][22][23] All participants were interviewed to obtain a list of medical conditions, and ongoing treatments and medications. Data were crosschecked with the patient's electronic patient record.…”

Comparison of the Efficacy of Three Loading Doses of Intravitreal Injection of Conbercept with Injection Combined with PDT for the Treatment of PCV

“…Several studies have reported that IVC is safe and effective in the treatment of eyes with PCV [12][13][14][15]. One study exhibited that conbercept had greater effects on regressing polypoidal lesions compared with intravitreal ranibizumab injection in eyes with PCV [13].…”

Changes in Retinal Nerve Fiber Layer Thickness after Multiple Injections of Novel VEGF Decoy Receptor Conbercept for Various Retinal Diseases

“…Its efficacy following intravitreal injection has been proven in vivo 91011. A phase II, randomized, double-masked clinical trial has compared two dosing regimens including monthly injection (Q1M) and 3 consecutive monthly injection plus as-needed PRN treatment (3 + PRN), and it suggested that either treatment regimen was similarly efficacious9.…”

“…A phase II, randomized, double-masked clinical trial has compared two dosing regimens including monthly injection (Q1M) and 3 consecutive monthly injection plus as-needed PRN treatment (3 + PRN), and it suggested that either treatment regimen was similarly efficacious9. Most ophthalmologists in China use the 3 + PRN regimen to treat patients with AMD11. The half-life of conbercept has not been calculated in human eyes, but in rabbit eyes is demonstrated to be 4.2 days, which is close to that of bevacizumab (4.3–6.61 days) and longer than that previously reported for ranibizumab (2.88–2.89 days)12.…”