Efficacy of Intravitreal Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration Patients with or without Polypoidal Choroidal Vasculopathy: A Meta-Analysis.

Abstract

Aims/Background The classification of polypoidal choroidal vasculopathy (PCV) as a subtype of neovascular age-related macular degeneration (nAMD) remained an ongoing controversy. This meta-analysis examines the efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents in nAMD patients with or without PCV. Methods A systematic search was conducted in four databases, including PubMed, EMBASE, MEDLINE, and Cochrane Library, from their inception to 1 July 2023. The outcome measure was the change in best-corrected visual acuity (BCVA) and center retinal thickness (CRT) from the baseline to different follow-up durations. Furthermore, sensitivity analysis was performed when significant heterogeneity was detected. Results This meta-analysis included sixteen studies involving 6679 patients, comprising 5070 non-PCV and 1609 PCV cases. The findings revealed that the improvement in BCVA at 6-month follow-up (mean difference (MD) = 0.05; 95% confidence interval (CI), 0.02 to 0.07; p = 0.0001) and the reduction in CRT at 3-month follow-up duration (MD = 10.29; 95% CI, 0.93 to 19.66; p = 0.03) were significantly greater in the PCV group compared to the non-PCV group. Conclusion This meta-analysis indicates that PCV may exhibit better short-term efficacy in response to anti-VEGF therapy than non-PCV. Systematic Review Registration PROSPERO (CRD42023445591).