Efficacy of aflibercept combined with 80% dose photodynamic therapy for pachychoroid neovasculopathy.

Abstract

To evaluate the short-term treatment outcomes of 80% dose photodynamic therapy (PDT) combined with intravitreal aflibercept injection (IVA) for symptomatic pachychoroid neovasculopathy (PNV) in a working-age population. We retrospectively reviewed a total of 137 eyes of 128 patients (108 males and 20 females) with PNV who were treated with combination therapy. All patients were working-age individuals, and the mean age was 49.0 ± 7.3 (range 33-65) years. Reduced-PDT (80% dose) was performed within 1 week of IVA. The presence of subretinal fluid  (SRF) at 1 month and changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), subfoveal choroidal thickness (SFCT), and fundus autofluorescence findings were assessed between at baseline and 1 month. One month after the combination therapy, SRF was resolved in 128 eyes (93.4%). The median (interquartile range) BCVA was 0.0 (- 0.08, 0.10)/- 0.08 (- 0.18, 0.05) (p < 0.001), the mean CRT was 374 ± 112/221 ± 36 (p < 0.001), and the mean SFCT was 416 ± 89/371 ± 92 (p < 0.001) at baseline and 1 month, respectively. Hypoautofluorescence, indicating macular atrophy was observed in 1 eye, and 1 eye developed transient visual loss at posttreatment. In terms of the rapid resolution of SRF and the improvement in VA, reduced-PDT combined with IVA can be a treatment option for PNV in the working-age population.