Characteristics and Outcomes of Anti-Vascular Endothelial Growth Factor Therapy in a Large Cohort of Patients with Pachychoroid Neovasculopathy.

Purpose: To examine the long-term visual and morphologic outcomes in a large series of patients with pachychoroid neovasculopathy (PNV) treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections. Methods: A retrospective, observational study of anti-VEGF injections in 249 eyes of 237 patients with PNV at 1 retina center over 7 years. Results: Mean patient age was 65.5 years and mean follow-up was 1.91 years (range 3 months to 7.14 years). At baseline, mean best-corrected visual acuity (BCVA) was 20/60 Snellen, with an improvement of 2.30 ETDRS letters by the study endpoint (P = .04). From baseline to endpoint, mean central subfield thickness decreased by 78.2 μm, and mean choroidal thickness decreased by 35.4 μm (each P < .05). Treat-and-extend was utilized in 192 eyes (77.9%), with a 42.3% recurrence rate on extension. Treatment cessation was trialed in 70 eyes (28.1%), of which 53 eyes required no further treatment. Adjunct photodynamic therapy was utilized in 34 eyes (13.7%), resulting in a mean vision improvement of 0.44 ETDRS letters, compared with a mean improvement of 2.30 ETDRS letters in patients who received anti-VEGF only (P = .6). Conclusions: Anti-VEGF therapy improved BCVA and anatomic features in this large cohort of patients with PNV. Continued treatment was required in 196 eyes (78.7%) at the study endpoint.