Subfoveal choroidal thickness and PCV
Reviewed by Saruban Pasu

This report studies the prognostic factors for visual improvement and the need for additional treatments at one year after the initial combination therapy of intravitreal ranibizumab injection or intravitreal aflibercept injection followed by PDT in eyes with PCV. Fifty-six eyes with treatment-naive subfoveal PCV were retrospectively reviewed during the 12-month follow-up period after the initial combination therapy involving intravitreal injection of anti-VEGF agents followed by PDT. Thirty-three eyes had aflibercept and 23 eyes had ranibizumab. Intravitreal injections were given one week prior to PDT. The subjects were followed up at three-month intervals until retreatment. Retreatment was conducted when residual or recurrent exudative changes were seen on OCT. There were no significant differences between each of the two intravitreal groups. In each of the groups both mean central macular thickness and subfoveal choroidal thickness were significantly reduced at every three month visit. A better visual outcome at 12 months was correlated with better initial BCVA, baseline smaller greatest liner diameter (on ICG), and baseline greater subfoveal choroidal thickness. In contrast, the visual gain from the baseline BCVA was correlated with worse initial BCVA, baseline smaller greatest linear diameter (on ICG), and baseline greater subfoveal choroidal thickness. Retreatment during the follow-up period was not significantly different between the two groups. Logistic regression analysis revealed that only a lesser subfoveal choroidal thickness was associated with the need for additional treatments involving intravitreal injection of anti-VEGF agents with or without PDT during the 12-month follow-up period after the initial combination therapy (P = 0.036). This is the first report demonstrating that baseline subfoveal choroidal thickness is a predictive factor of visual improvement at 12 months after combination therapy involving intravitreal ranibizumab injection or intravitreal aflibercept injection followed by PDT in eyes with PCV.

Choroidal thickness as a prognostic factor of photodynamic therapy with aflibercept or ranibizumab for polypoidal choroidal vasculopathy.
Sakirada Y, Sugiyama A, Tanabe N, et al.
RETINA
2017;37(10):1866-72.