Combination Therapy May Increase Lesion Closure in PCV - Summary - MDSpire
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Combination Therapy May Increase Lesion Closure in PCV
The combination of photodynamic therapy and intravitreal aflibercept did not improve 1-year visual acuity outcomes compared with aflibercept monotherapy.
To evaluate the efficacy of reduced-fluence photodynamic therapy combined with intravitreal aflibercept injections in patients with polypoidal choroidal vasculopathy, focusing on changes in best-corrected visual acuity.
Key Findings:
Mean visual acuity gains were similar but not statistically significant: 12.7 letters (combination therapy) vs. 11.9 letters (monotherapy).
One-third of patients in both groups gained at least 15 Early Treatment Diabetic Retinopathy Study letters, with no patients losing five or more letters.
Interpretation:
Combination therapy achieved higher early polypoidal lesion closure rates but did not demonstrate superior visual acuity outcomes compared to monotherapy, indicating no clinically relevant functional benefits.
Limitations:
Only 60 patients enrolled instead of the planned 160 due to COVID-19 and a verteporfin shortage, limiting the ability to establish superiority or non-inferiority for visual acuity outcomes.
Secondary outcomes were not adjusted for multiple analyses, which should be considered hypothesis generating.
Conclusion:
Greater polypoidal lesion closure with combination therapy was not associated with clinically relevant functional outcomes in this trial, suggesting that further research is needed.
