Effect and safety of aflibercept in the treatment of polypoidal choroidal vasculopathy with ranibizumab-resistant serous pigment epithelial detachment

Authors: Zhou Pengyi,  Yang Lin,  Xu Youmei,  Pan Meng,  Guo Ju,  Du Liping,  Jin Xuemin
DOI: 10.3760/cma.j.cn115989-20211206-00671
Published 2022-07-10
Cite asChin J Exp Ophthalmol, 2022, 40(7): 632-638.

Abstract

Objective

To evaluate the effectiveness and safety of intravitreal injection of different doses of aflibercept for polypoidal choroidal vasculopathy (PCV) with serous pigment epithelial detachment (PED) resistant to ranibizumab.

Methods

A non-randomized controlled clinical study was conducted.Seventy-three eyes of 73 patients with PCV and serous PED resistant to ranibizumab were enrolled at the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2020.All patients were treated by intravitreal injection of 2 mg or 4 mg aflibercept according to patients’ willingness.2 mg aflibercept or 4 mg aflibercept was intravitreally injected monthly for three consecutive months following pro re nata (PRN) regimen in 2 mg aflibercept group (38 eyes) and 4 mg aflibercept group (35 eyes), respectively.PED height and central macular thickness (CMT) were measured by optical coherence tomography, and the best corrected visual acuity (BCVA) was examined with a visual acuity chart and converted to logarithm of the minimum angle of resolution (LogMAR) unit before injection and 1 month, 2, 3, 6 months from the first injection.Intraocular pressure and treatment-related adverse events were recorded.This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2021-KY-1252).Written informed consent was obtained from each patient prior to entering study cohort.

Results

Thirty-three patients (86.84%) in 2 mg aflibercept group and 30 patients (85.71%) in 4 mg aflibercept group finished the treatment and follow-up, respectively. The PED, BCVA and CMT before treatment and at the end of follow-up were (379.24±95.50) and (280.09±120.50)μm, 0.68±0.27 and 0.51±0.19, (393.96±100.81) and (291.70±44.09)μm in 2 mg aflibercept group, respectively, showing statistically significant differences (all at P<0.05).The PED, BCVA and CMT before treatment and at the end of follow-up were (393.07±93.76) and (278.63±145.07)μm, 0.66±0.31 and 0.48±0.22, (377.43±79.61) and (284.67±84.88)μm in 4 mg aflibercept group, respectively, with statistically significant differences (all at P<0.05).The CMT value in 4 mg aflibercept group was significantly lower than that in the 2 mg aflibercept group in one month after injection (P<0.05).No severe ocular and systemic adverse events were found during the follow-up, such as retinal detachment, endophthalmitis, cataract, and persistent high intraocular pressure.

Conclusions

Both 2 mg and 4 mg aflibercept can effectively treat ranibizumab-resistant PCV with serous PED, and improve the anatomical structure of retina and BCVA.4 mg aflibercept can accelerate the recovery of PED and CMT.

Key words:

Polyps; Choroidal neovascularization; Pigment epithelial detachment, serous; Introvitreal injection; Recombinant fusion proteins/therapeutic use; Treatment outcome; Visual acuity

Contributor Information

Zhou Pengyi

Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Yang Lin

Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Xu Youmei

Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Pan Meng

Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Guo Ju

Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Du Liping

Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Jin Xuemin

Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

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