Purpose: To compare the 1-year outcomes of treat-and-extend and pro re
nata (PRN) treatment regimens with aflibercept for polypoidal choroidal
vasculopathy (PCV), by the means of visual acuity (VA), frequency of
recurrence of polypoidal lesions and developed fibrosis, and the number
of intravitreal injections, and thus to determine which one is
preferable in the maintenance phase in PCV. Methods: In our prospective
study, only naive and previously untreated PCV patients were included.
Initially one session of photodynamic therapy (PDT) and three monthly
intravitreal injections of 2.0 mg aflibercept (IAIs) were applied in 38
eyes. After this loading phase, they were re-examined and 30 PCV eyes
with no exudative phenomena were included in the study. They were
divided in two groups; in the first one (16 patients) the PRN treatment
modality of IAIs was applied, while in the second one (14 patients) the
treat-and-extend regimen was applied. Results: Over a 12-month period,
VA significantly improved in treat-and-extend group (logMAR BCVA 0.41
+/- 0.15 vs 0.57 +/- 0.24 at baseline, p = 0.044), while in the PRN
group VA remained stable (logMAR BCVA 0.70 +/- 0.36 vs 0.65 +/- 0.18 at
baseline, p = 0.61). During the maintenance phase, the patients of
treat-and-extend group did not encounter development/progression of
fibrosis or any recurrent episodes, whereas the patients of PRN group
had significantly more recurrent episodes (0 vs 1.37 +/- 0.5, p < 0.001)
and the frequency of development/progression of fibrosis was
significantly higher (0% vs 44%, p = 0.02). However, the
treat-and-extend treatment regimen was accompanied by significantly more
administered IAIs (6 +/- 0 vs 5.13 +/- 1.08, p = 0.006). Conclusion: We
highlighted the superiority of treat-and-extend regime with IAIs, which
seems to yield better functional outcomes by preventing recurrence and
subfoveal fibrosis, although a greater number of injections is required
