A Comparison of Efficacies of Aflibercept and Ranibizumab, Depending on the Angiographic Classification of Polypoidal Choroidal Vasculopathy.
10.3341/jkos.2017.58.12.1356
- Author:
Gahyung RYU
1
;
Donghyoun NOH
;
Junyeop LEE
;
Min SAGONG
Author Information
1. Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea. msagong@ynu.ac.kr
- Publication Type:Original Article
- Keywords:
Aflibercept;
Angiographic classification;
Polyp closure;
Polypoidal choroidal vasculopathy;
Ranibizumab
- MeSH:
Angiography;
Choroid*;
Classification*;
Endothelial Growth Factors;
Humans;
Indocyanine Green;
Polyps;
Ranibizumab*;
Retrospective Studies;
Visual Acuity
- From:Journal of the Korean Ophthalmological Society
2017;58(12):1356-1366
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To compare the short-term efficacy of intravitreal aflibercept and ranibizumab treatment according to the subtypes of polypoidal choroidal vasculopathy (PCV) based on indocyanine green angiography (ICGA). METHODS: Fifty-five treatment naïve patients with PCV who underwent intravitreal anti-vascular endothelial growth factor (VEGF) (ranibizumab, 26 eyes; aflibercept, 29 eyes) injection were retrospectively analyzed. Based on ICGA, subjects with feeder and draining vessels were defined as type 1 PCV (33 eyes), and subjects who did not have either feeder or draining vessels, but had branch vascular networks were defined as type 2 PCV (22 eyes). The complete polyp regression was assessed at 3 months after the initial treatment using ICGA. Changes in best-corrected visual acuity (BCVA) and optical coherence tomographic parameters were evaluated at 3 and 6 months. RESULTS: Patients with type 1 PCV showed a higher complete polyp regression percentage (p = 0.034) and better visual improvement (p = 0.017) after three monthly injections compared to patients with Type 2 PCV. At 3 and 6 months, the BCVA was significantly improved in type 1 PCV patients, but not in type 2 PCV patients. In patients with type 1 PCV, the aflibercept-treated group showed a better response in anatomical outcomes (p = 0.020), and complete polyp regression percentage (p = 0.027; dry macula) than the ranibizumab-treated group, and only the aflibercept-treated group showed a significant improvement of BCVA at 3 and 6 months. In patients with type 2 PCV, there were no significant differences in visual and anatomical outcome between the anti-VEGF agents. CONCLUSIONS: Type 1 PCV showed better visual improvement with a higher percentage of polyp regression than type 2 PCV. Anatomical changes were greater in patients treated with aflibercept than with ranibizumab, particularly in patients with type 1 PCV. These results suggest that a consideration of angiographic features is important in establishing a treatment strategy for patients with PCV.
