Subfoveal choroidal thickness as a predictor of treatment response to anti-vascular endothelial growth factor therapy for polypoidal choroidal vasculopathy

Graefes Arch Clin Exp Ophthalmol. 2016 Aug;254(8):1497-1503. doi: 10.1007/s00417-015-3221-x. Epub 2015 Dec 1.

Abstract

Purpose: To investigate whether subfoveal choroidal thickness predicted treatment response to anti-vascular endothelial growth factor (VEGF) in polypoidal choroidal vasculopathy (PCV).

Methods: This retrospective observational case series included 66 eyes of 60 patients who were diagnosed with new-onset PCV and who were followed for a minimum of 6 months. Patients received three monthly intravitreal injections of 0.5 mg ranibizumab or 1.25 mg bevacizumab, at baseline, month 1, and month 2. "Good responders" were defined as those who showed complete resolution of subretinal and/or intraretinal fluid at month 3 after the loading injections, whereas "poor responders" were defined as those who showed persistent retinal fluid on optical coherence tomography (OCT) at month 3 after treatment. Differences in best-corrected visual acuity, indocyanine green angiography, and spectral domain-OCT findings at baseline were analyzed between the two groups.

Results: The mean patient age was 68.2 ± 9.7 years, and the mean follow-up period was 27 ± 21 months. The mean subfoveal choroidal thickness was 273 ± 117 μm, and choroidal vascular hyperpermeability was observed in 35 eyes (53.0 %). Thirty-three eyes (50 %) showed good response to treatment, and a thinner subfoveal choroid at baseline significantly correlated with favorable treatment response (P = 0.024). However, there was no significant relationship between treatment response and choroidal vascular hyperpermeability (P = 0.999).

Conclusions: The subfoveal choroid was found to be significantly thinner among patients who achieved complete resolution of macular exudation after three loading injections of anti-VEGF agents.

Keywords: Anti-vascular endothelial growth factor; Polypoidal choroidal vasculopathy; Subfoveal choroidal thickness.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage
  • Bevacizumab / administration & dosage*
  • Choroid / blood supply*
  • Choroid / diagnostic imaging
  • Choroid Diseases / diagnosis
  • Choroid Diseases / drug therapy*
  • Choroid Diseases / physiopathology
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Ranibizumab / administration & dosage*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Ranibizumab