Factors predicting fluid-free retina and complete polypoidal regression in polypoidal choroidal vasculopathy eyes receiving 2-mg aflibercept treatments

Abstract

Purpose To determine predictive factors for fluid-free retina and complete polypoidal choroidal vasculopathy (PCV) regression following 1-year aflibercept monotherapy in PCV. Methods Multicenter, retrospective cohort of treatment-naïve PCV eyes receiving 2-mg aflibercept treatments for 1 year from 2015 to 2018 collected demographic data, de-identified fundus photography, optical coherence tomography (OCT), and indocyanine green angiography (ICGA) images at baseline and 1-year of study eyes were graded to identify baseline features and outcomes. Results Of 100 study eyes, mean age [SD] was 63.8 [8] years; 100% were Thai patients. At 1 year, eighty-five eyes (85%) had fluid-free retina; 48 eyes (48%) had complete polypoidal regression. Multivariate analyses showed baseline OCT and ICGA features associated with 1-year outcomes: sharply-peaked PED with/without double-layer sign on OCT and smaller lesion size on ICGA (<1 disc diameter) were associated with fluid-free retina (OR 6.57; 95%CI 1.27–34.10, and OR 7.86; 95%CI 1.33–46.54, respectively). Multilobulated PED on OCT was associated with poor (20/200 or worse) final VA (OR 4.53; 95%CI 1.33–15.36). Smaller number (1−5) of polypoidal lesions on ICGA was associated with complete polypoidal regression (OR 4.87; 95%CI 1.44–16.43) Conclusion Results suggest baseline OCT and ICGA features could predict fluid-free retina and complete polypoidal regression following aflibercept monotherapy.