Intravitreal aflibercept for submacular hemorrhage secondary to neovascular age-related macular degeneration and polypoidal choroidal vasculopathy

摘要

Purpose To evaluate the efficacy of intravitreal aflibercept monotherapy for submacular hemorrhage secondary to neovascular age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). Methods This prospective, phase 4 clinical trial included 29 patients diagnosed with fovea-involving submacular hemorrhage secondary to neovascular AMD (7 patients) or PCV (22 patients). Patients were initially administered 3 monthly aflibercept injections, followed by 1 injection every 2 months. The primary outcome measure was changes in Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) during the 56-week study period. Other key outcome measures were the proportion of patients who exhibited changes in BCVA of >= 15 ETDRS letters from baseline and changes in central retinal thickness (CRT). Results The mean size of hemorrhage was 6.2 +/- 4.8-disc-diameter area. The mean BCVA significantly improved from 52.9 +/- 17.8 ETDRS letters at week 0 (baseline) to 71.8 +/- 16.1 letters at week 56 (P = 15 letters was noted in 16 patients (55.2%), whereas none of the patients experienced a loss of >= 15 letters. The mean CRT significantly decreased from 498.9 +/- 194.2 mu m at week 0 to 248.3 +/- 45.0 mu m at week 56 (P < 0.001). During the study period, retinal break developed in one patient. Conclusions Intravitreal aflibercept administered every 2 months after the 3 initial monthly doses was found to be an effective and safe treatment method for submacular hemorrhage secondary to neovascular AMD.