| A Comparison of Efficacies of Aflibercept and Ranibizumab, Depending on the Angiographic Classification of Polypoidal Choroidal Vasculopathy. |
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Gahyung Ryu, Donghyoun Noh, Junyeop Lee, Min Sagong |
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Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea. msagong@ynu.ac.kr |
| 결절맥락막혈관병증의 혈관조영 분류에 따른 애플리버셉트와 라니비주맙 치료의 효과 비교 |
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류가형⋅노동현⋅이준엽⋅사공민 |
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영남대학교 의과대학 안과학교실 |
Correspondence:
Min Sagong,
Email: msagong@ynu.ac.kr
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Received: 26 July 2017 • Revised: 12 October 2017 • Accepted: 20 November 2017 |
| Abstract |
PURPOSE
To compare the short-term efficacy of intravitreal aflibercept and ranibizumab treatment according to the subtypes of polypoidal choroidal vasculopathy (PCV) based on indocyanine green angiography (ICGA). METHODS: Fifty-five treatment naïve patients with PCV who underwent intravitreal anti-vascular endothelial growth factor (VEGF) (ranibizumab, 26 eyes; aflibercept, 29 eyes) injection were retrospectively analyzed. Based on ICGA, subjects with feeder and draining vessels were defined as type 1 PCV (33 eyes), and subjects who did not have either feeder or draining vessels, but had branch vascular networks were defined as type 2 PCV (22 eyes). The complete polyp regression was assessed at 3 months after the initial treatment using ICGA. Changes in best-corrected visual acuity (BCVA) and optical coherence tomographic parameters were evaluated at 3 and 6 months. RESULTS: Patients with type 1 PCV showed a higher complete polyp regression percentage (p = 0.034) and better visual improvement (p = 0.017) after three monthly injections compared to patients with Type 2 PCV. At 3 and 6 months, the BCVA was significantly improved in type 1 PCV patients, but not in type 2 PCV patients. In patients with type 1 PCV, the aflibercept-treated group showed a better response in anatomical outcomes (p = 0.020), and complete polyp regression percentage (p = 0.027; dry macula) than the ranibizumab-treated group, and only the aflibercept-treated group showed a significant improvement of BCVA at 3 and 6 months. In patients with type 2 PCV, there were no significant differences in visual and anatomical outcome between the anti-VEGF agents. CONCLUSIONS: Type 1 PCV showed better visual improvement with a higher percentage of polyp regression than type 2 PCV. Anatomical changes were greater in patients treated with aflibercept than with ranibizumab, particularly in patients with type 1 PCV. These results suggest that a consideration of angiographic features is important in establishing a treatment strategy for patients with PCV. |
| Key Words:
Aflibercept;Angiographic classification;Polyp closure;Polypoidal choroidal vasculopathy;Ranibizumab |
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