Clinical Ophthalmology (Apr 2021)

Effects of Intravitreous Aflibercept Injection in Pachychoroid Neovasculopathy: Comparison with Typical Neovascular Age-Related Macular Degeneration

  • Elfandi S,
  • Ooto S,
  • Miyata M,
  • Ueda-Arakawa N,
  • Subhi Y,
  • Yamashiro K,
  • Tamura H,
  • Oishi A,
  • Hata M,
  • Yoshimura N,
  • Tsujikawa A

Journal volume & issue
Vol. Volume 15
pp. 1539 – 1549

Abstract

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Sufian Elfandi,1 Sotaro Ooto,1 Manabu Miyata,1 Naoko Ueda-Arakawa,1 Yousif Subhi,1,2 Kenji Yamashiro,1 Hiroshi Tamura,1 Akio Oishi,1 Masayuki Hata,1 Nagahisa Yoshimura,1 Akitaka Tsujikawa1 1Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; 2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkCorrespondence: Sotaro OotoDepartment of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine Email [email protected]: To compare the 12-month efficacy of intravitreous aflibercept (IVA) injection between eyes with pachychoroid neovasculopathy and neovascular age-related macular degeneration (AMD).Methods: Retrospective, comparative case series analysis. Twenty-seven eyes with pachychoroid neovasculopathy and sixty-three eyes with neovascular AMD. All patients received three initial monthly, followed by bimonthly, IVA injections.Results: Twelve months after initial treatment, the mean best-corrected visual acuity (BCVA) had improved both in pachychoroid neovasculopathy (from 0.28 to 0.14 logMAR; P = 0.001) and neovascular AMD (from 0.40 to 0.29 logMAR; P < 0.001). Twelve months after initial treatment, eyes with pachychoroid neovasculopathy exhibited decreased mean central retinal thickness (CRT) and subfoveal choroidal thickness (both, P < 0.001) and presence of polyps (P = 0.039) and improved integrity of external limiting membrane (ELM) (P = 0.008) and ellipsoid zone band (P = 0.001). At the 12-month follow-up, 77% and 68% of eyes with pachychoroid neovasculopathy and neovascular AMD, respectively, exhibited dry macula (P = 0.30). Baseline CRT was correlated with 12-month BCVA in eyes with pachychoroid neovasculopathy (P = 0.02). In eyes with neovascular AMD, CRT (P = 0.005) and presence of intact ELM (P = 0.007) were significant predictors of 12-month BCVA.Conclusion: Periodic IVA injection leads to anatomical and functional improvement in eyes with pachychoroid neovasculopathy and in eyes with neovascular AMD.Keywords: age-related macular degeneration, aflibercept, pachychoroid neovasculopathy, choroidal thickness

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