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. 2022 Nov 22;8(1):82.
doi: 10.1186/s40942-022-00432-x.

Polypoidal choroidal vasculopathy-characteristics and response to treatment with bevacizumab in caucasian patients

Fidaa El Zhalka  1 , Elad Moisseiev  2   3 , Alexander Rubowitz  2   3
Affiliations

Polypoidal choroidal vasculopathy-characteristics and response to treatment with bevacizumab in caucasian patients

Fidaa El Zhalka et al. Int J Retina Vitreous. .

Abstract

Purpose: To investigate the features and treatment response in Caucasian patients with polypoidal choroidal vasculopathy (PCV), initially treated with bevacizumab.

Methods: 45 eyes of 43 treatment-naïve patients with PCV were included in this retrospective study, all uniformly initially treated with three bevacizumab injections monthly. OCT characteristics and clinical parameters were recorded and analyzed at presentation, after the initial 3 bevacizumab injections and at the final follow up period.

Results: Following 3 monthly bevacizumab injections visual acuity significantly improved with a mean gain of one line of vision. Central macular thickness (CMT) significantly improved from a mean of 402.1 ± 130.8 μm at presentation to 322.0 ± 96.8 μm (p < 0.01). Subretinal fluid, intraretinal fluid and submacular hemorrhage significantly improved. 53% were later switched to aflibercept and showed better response in the central macular thickness in comparison to those in which bevacizumab injections were continued. No correlation was found between the presence of pachyvessels or increased choroidal thickness and the improvement in VA or CMT.

Conclusion: Fixed first-line treatment with intravitreal bevacizumab monotherapy in non-Asian PCV patients achieves satisfactory visual and anatomical outcomes.

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Figures

Fig. 1
Fig. 1
Response to treatment in patient without pachychoroid and pachyvessels. A 78 years old patient, who presented with metamorphopsia OD and o VA of 20\50 (0.4 LogMar). OCT showed a PED with SRF, thin choroid and no pachyvessels (A). OCT 4 weeks after three monthly bevacizumab injections showed complete resolution of the SRF but the PED enlarged a little, VA improved to 20\40 (0.3 LogMar) (B)
Fig. 2
Fig. 2
Response to treatment in patient with pachychoroid and pachyvessels. A 62 years old patient, who presented with a VA of 2.3 (LogMar), and OCT revealed pachychoroid of 370 μm with pachyvessels, a PED with SRF and hard exudates (A). OCT 4 weeks after three monthly bevacizumab injections showed improvement in the SRF, the PED enlarged. without change in the VA (B)
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