Prognostic factors in the treatment of polypoidal choroidal vasculopathy with conbercept: a post hoc analysis of the STAR study.

Abstract

Background: A post hoc analysis of the STAR study, which was a 48-week, phase IV, multicenter randomized controlled multicenter clinical trial was performed. This study aims to identify the baseline factors associated with visual and anatomic changes over 48 weeks in the treatment of active polypoidal choroidal vasculopathy (PCV) with conbercept.

Methods: In the STAR study, 249 participants were randomized to either the 3 + Q12W (3 monthly injections followed by injections every 12 weeks) or 3 + TAE (3 monthly injections followed by treat and extend regimen) group. The association of 27 baseline factors with three outcomes-changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), and maximum retinal thickness (MRT) from baseline to 48 weeks-was investigated using univariate regression analysis followed by multivariate linear regression analysis.

Results: The final multivariate model indicated that worse baseline BCVA (P < 0.01), CRT ≤ 400 μm (P < 0.01), fewer polypoidal lesions (P < 0.01), and younger age at baseline (P = 0.04) were associated with greater BCVA gain at week 48. Higher CRT and MRT at baseline were associated with a greater reduction in CRT and MRT at week 48, separately (P < 0.01 and P < 0.01, respectively). Smaller pigment epithelial detachment (PED) volume at baseline was associated with greater reductions in CRT and MRT at week 48 (both P < 0.01). Eyes with relatively good BCVA (> 73 letters) at baseline exhibited lower reductions in CRT and MRT at week 48 (P < 0.01 and P = 0.02, respectively). At week 48, eyes with hemorrhagic PEDs showed greater reductions in CRT and MRT than those with fibrovascular PEDs (P = 0.02 and P = 0.03, respectively). Furthermore, eyes with shallow irregular or sharp-peaked PEDs exhibited greater reductions in CRT (both P < 0.01) and MRT (P = 0.01 and P < 0.01, respectively) than those with multilobular PEDs from baseline to week 48.

Conclusions: In Chinese patients with PCV receiving intravitreal injections of conbercept, baseline characteristics, including age, BCVA, CRT, MRT, number of polypoidal lesions, PED volume, and PED types and morphology, served as predictors of visual and anatomical changes over 48 weeks.