Initial treatment for polypoidal choroidal vasculopathy: Ranibizumab combined with photodynamic therapy or fixed-dosing aflibercept monotherapy

摘要

Purpose: To compare the 2-year outcomes of combination therapy using intravitreal ranibizumab and photodynamic therapy with those of fixed-dosing intravitreal aflibercept monotherapy as initial treatment for treatment-naive polypoidal choroidal vasculopathy. Methods: We retrospectively reviewed 63 eyes of 61 patients with treatment-naive polypoidal choroidal vasculopathy who had undergone at least 24 months of follow-up. In total, 43 eyes underwent intravitreal ranibizumab-photodynamic therapy combination therapy and 20 eyes underwent fixed-dosing intravitreal aflibercept monotherapy. Visual outcomes and the number of treatments were compared between the two groups. Results: The mean logarithm of minimal angle of resolution best-corrected visual acuity significantly improved from 0.48 +/- 0.41 at baseline to 0.30 +/- 0.47 at 24 months in the intravitreal ranibizumab-photodynamic therapy group (p = .0002) and from 0.30 +/- 0.18 at baseline to 0.16 +/- 0.18 at 24 months in the intravitreal aflibercept group (p = .004), with no significant intergroup differences. The mean number of intravitreal ranibizumab or intravitreal aflibercept injections over 24 months was 5.7 +/- 4.5 in the intravitreal ranibizumab-photodynamic therapy group and 12.2 +/- 3.8 in the intravitreal aflibercept group (p < .0001). Conclusion: The intravitreal ranibizumab-photodynamic therapy combination therapy was noninferior to fixed-dosing intravitreal aflibercept monotherapy in improving visual acuity and required fewer injections.