Korean J Ophthalmol.  2015 Dec;29(6):404-410. 10.3341/kjo.2015.29.6.404.

Intravitreal Anti-vascular Endothelial Growth Factor for Newly Diagnosed Symptomatic Polypoidal Choroidal Vasculopathy with Extrafoveal Polyps

• Kim JH
• Lee DW
• Choi SC
• Kim JW
• Lee TG
• Kim CG
• Cho HJ

• KMID: 2363848
• DOI: http://doi.org/10.3341/kjo.2015.29.6.404

Abstract

PURPOSE
To evaluate the 12-month outcome of anti-vascular endothelial growth factor (VEGF) treatment for extrafoveal polypoidal choroidal vasculopathy (PCV).
METHODS
This retrospective observational study included 32 eyes of 32 patients newly diagnosed with extrafoveal PCV (polyps located more than 500 microm from the center of the fovea). Patients were treated with intravitreal ranibizumab, bevacizumab, or both. The best-corrected visual acuity (BCVA) and central foveal thickness (CFT) at diagnosis and at 12 months were compared. Eyes were divided into two groups according to the presence of submacular hemorrhage. The BCVA in each group was compared at baseline and at 12 months.
RESULTS
During the 12-month study period, patients received an average of 4.0 +/- 1.1 anti-VEGF injections. The BCVA at baseline, three-month post-diagnosis, and 12-month post-diagnosis was 0.59 +/- 0.40, 0.34 +/- 0.38, and 0.38 +/- 0.38, respectively. The BCVA at 12 months was significantly better than the baseline value (p = 0.002). The CFT at baseline, three-month, and 12-month post-diagnosis was 477.1 +/- 194.2 microm, 214.5 +/- 108.8 microm, and 229.8 +/- 106.1 microm, respectively. The CFT at 12 months was significantly lower than the baseline value (p < 0.001). A significant improvement in BCVA was noted in eyes with and without submacular hemorrhage (n = 13, p = 0.032 and n = 19, p = 0.007, respectively).
CONCLUSIONS
Anti-VEGF therapy was beneficial in extrafoveal PCV, regardless of the presence of submacular hemorrhage.

Keyword

Age-related macular degeneration; Anti-vascular endothelial growth factor; Extrafoveal; Polypoidal choroidal vasculopathy; Treatment outcome

MeSH Terms

Aged
Angiogenesis Inhibitors/*therapeutic use
Bevacizumab/therapeutic use
Choroidal Neovascularization/diagnosis/*drug therapy/physiopathology
Female
Fluorescein Angiography
Fovea Centralis/pathology
Humans
Intravitreal Injections
Male
Microscopy, Confocal
Middle Aged
Polyps/diagnosis/*drug therapy
Ranibizumab/therapeutic use
Retrospective Studies
Tomography, Optical Coherence
Treatment Outcome
Vascular Endothelial Growth Factor A/*antagonists & inhibitors
Visual Acuity/drug effects/physiology
Angiogenesis Inhibitors
Bevacizumab
Ranibizumab
Vascular Endothelial Growth Factor A

Figure

• 

  Fig. 1 Changes in logarithm of minimal angle of resolution best-corrected visual acuity (A) and central foveal thickness (B) in eyes with extrafoveal polypoidal choroidal vasculopathy treated with anti-vascular endothelial growth factor therapy.

• 

  Fig. 2 Fundus photography (A), indocyanine green angiography (B), and optical coherence tomography (C,D) images from an eye diagnosed with extrafoveal polypoidal choroidal vasculopathy without submacular hemorrhage. The eye was treated with three intravitreal anti-vascular endothelial growth factor injections. The best-corrected visual acuity improved from 20 / 30 at diagnosis to 20 / 25 at 12 months. Images (A), (B), and (C) at diagnosis; image (D) at 12 months. The arrow (B) indicates polypoidal lesions.

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