Ophthalmology and Therapy (Feb 2024)

Six-Year Outcomes in Subjects with Polypoidal Choroidal Vasculopathy in the EVEREST II Study

  • Kelvin Yi Chong Teo,
  • Kyu-Hyung Park,
  • Nor Fariza Ngah,
  • Shih-Jen Chen,
  • Paisan Ruamviboonsuk,
  • Ryusaburo Mori,
  • Nagako Kondo,
  • Won Ki Lee,
  • Rajesh Rajagopalan,
  • Ryo Obata,
  • Ian Y. H. Wong,
  • Caroline Chee,
  • Hiroko Terasaki,
  • Tetsuju Sekiryu,
  • Shih-Chou Chen,
  • Yasuo Yanagi,
  • Shigeru Honda,
  • Timothy Y. Y. Lai,
  • Chui Ming Gemmy Cheung

DOI
https://doi.org/10.1007/s40123-024-00888-0
Journal volume & issue
Vol. 13, no. 4
pp. 935 – 954

Abstract

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Abstract Introduction The EVEREST II study previously reported that intravitreally administered ranibizumab (IVR) combined with photodynamic therapy (PDT) achieved superior visual gain and polypoidal lesion closure compared to IVR alone in patients with polypoidal choroidal vasculopathy (PCV). This follow-up study reports the long-term outcomes 6 years after initiation of the EVEREST II study. Methods This is a non-interventional cohort study of 90 patients with PCV from 16 international trial sites who originally completed the EVEREST II study. The long-term outcomes were assessed during a recall visit at about 6 years from commencement of EVEREST II. Results The monotherapy and combination groups contained 41 and 49 participants, respectively. The change in best-corrected visual acuity (BCVA) from baseline to year 6 was not different between the monotherapy and combination groups; − 7.4 ± 23.0 versus − 6.1 ± 22.4 letters, respectively. The combination group had greater central subfield thickness (CST) reduction compared to the monotherapy group at year 6 (− 179.9 vs − 74.2 µm, p = 0.011). Fewer eyes had subretinal fluid (SRF)/intraretinal fluid (IRF) in the combination versus monotherapy group at year 6 (35.4% vs 57.5%, p = 0.032). Factors associated with BCVA at year 6 include BCVA (year 2), CST (year 2), presence of SRF/IRF at year 2, and number of anti-VEGF treatments (years 2–6). Factors associated with presence of SRF/IRF at year 6 include combination arm (OR 0.45, p = 0.033), BCVA (year 2) (OR 1.53, p = 0.046), and presence of SRF/IRF (year 2) (OR 2.59, p = 0.042). Conclusion At 6 years following the EVEREST II study, one-third of participants still maintained good vision. As most participants continued to require treatment after exiting the initial trial, ongoing monitoring and re-treatment regardless of polypoidal lesion status are necessary in PCV. Trial Registration ClinicalTrials.gov identifier, NCT01846273.

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