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Erschienen in:
17.08.2016 | Retinal Disorders
Comparison of initial treatment between 3-monthly intravitreal aflibercept monotherapy and combined photodynamic therapy with single intravitreal aflibercept for polypoidal choroidal vasculopathy
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 2/2017
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Purpose
To compare the efficacy of two different initial treatment modalities on visual outcome, need for retreatment, and angiographic improvement during 12-month follow-up for polypoidal choroidal vasculopathy (PCV).
Methods
A retrospective medical chart review was performed for 66 eyes from 66 patients with treatment-naïve PCV. Visual and angiographic improvements and the incidence of retreatment for recurrence or residual pathology were compared between two groups that underwent either intravitreal aflibercept injection (IAI) monotherapy (n = 33) or combined photodynamic therapy (PDT) with IAI (n = 33).
Results
Best-corrected visual acuity improved significantly (P < 0.001) in both groups at each of the 3-monthly visits during the 12-month follow-up period, with no difference between groups at 12 months (P = 0.56). The relative risk of the need for retreatment was significantly lower in the combined PDT and IAI group than in the IAI monotherapy group (P = 0.007). Angiographic regression of polypoidal vascular lesions occurred more frequently in the combined PDT group than in the IAI monotherapy group at 3 (87.5 % vs 56.7 %) and 12 months (68.8 % vs 60.0 %) (p = 0.0065 and p = 0.47 respectively).
Conclusions
The combination of PDT with IAI as the initial treatment for PCV may be superior to IAI monotherapy in terms of disease-stabilizing efficacy, but with equivalent visual gain at 12 months.