One-year outcomes of half-fluence photodynamic therapy combined with intravitreal injection of aflibercept for pachychoroid neovasculopathy without polypoidal lesions.

PURPOSE: To evaluate the 1-year efficacy of half-fluence photodynamic therapy (HFPDT) combined with intravitreal aflibercept injection on treatment-naïve pachychoroid neovasculopathy (PNV) without polypoidal lesions.

STUDY DESIGN: Retrospective, interventional case series PATIENTS AND METHODS: We retrospectively studied 21 eyes with treatment-naïve PNV and assessed the best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CCT), pachyvessel vertical diameter, and choroidal neovascularization thickness (CNVT) at the fovea over a 12-month period.

RESULTS: The median BCVA was 0.15 at baseline, 0.00 (P < .05) at 3 months, 0.05 at 6 months, and -0.08 (P < .05) at 12 months. The BCVA was significantly improved at 3 months and 12 months as compared with the baseline BCVA. The median CMT was 230 μm at baseline, 140 μm (P < .01) at 3 months, 150 μm (P < .01) at 6 months, and 150 μm (P < .01) at 12 months. The median CCT was 386 μm at baseline, 347 μm (P < .01) at 3 months, 331 μm (P < .01) at 6 months, and 352 μm (P < .01) at 12 months. The median pachyvessel vertical diameter was 309 μm at baseline, 246 μm (P < .01) at 3 months, 232 μm (P < .01) at 6 months, and 242 μm (P < .01) at 12 months. The median CNVT was 28 μm at baseline, 17 μm (P < .01) at 3 months, 19 μm (P < .05) at 6 months, and 21 μm (P < .05) at 12 months. The CMT, CCT, pachyvessel vertical diameter, and CNVT were significantly decreased at 3, 6, and 12 months as compared with those at baseline. Whilst 17 eyes (81.0%) showed no signs of CNV recurrence during the 12-month period, 4 eyes (19.0%) required additional combination therapy.

CONCLUSIONS: HFPDT combined with intravitreal aflibercept injection may effectively improve BCVA and ameliorate exudative changes in eyes with PNV without polypoidal lesions for up to 1 year.