ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2019-2-151-158ophthalmology-947Research ArticleОБЗОРЫREVIEWSЛечение полипоидной хориоидальной васкулопатии: фотодинамическая терапия, анти-VEGF терапия или их комбинация? Обзор современных клинических исследованийPolypoidal Choroidal Vasculopathy Treatment: Photodynamic Therapy, Anti-VEGF Monotherapy or Combination. Review of Clinical Studieshttps://orcid.org/0000-0001-5191-3385ПедановаЕ. К.PedanovaE. K.

кандидат медицинских наук, научный сотрудник,

Бескудниковский бульвар, 59а, Москва, 127486

PhD,

researcher Beskudnikovskiy blvd, 59A, Moscow, 127486

elenamntk@mail.ruhttps://orcid.org/0000-0003-2519-8941ДогаА. В.DogaA. V.

доктор медицинских наук, профессор, заместитель директора по научно-клинической работе,

Бескудниковский бульвар, 59а, Москва, 127486

MD, professor, deputy CEO for Scientific and Clinical work,

Beskudnikovskiy blvd, 59A, Moscow, 127486

ФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова» Минздрава РоссииРоссияS. Fyodorov Eye Microsurgery Federal State Institution Beskudnikovskiy blvd, 59A, Moscow, 127486Russian FederationФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова» Минздрава РоссииРоссияS. Fyodorov Eye Microsurgery Federal State InstitutionRussian Federation201926062019162151158Copyright © Педанова Е.К., Дога А.В., 20192019Педанова Е.К., Дога А.В.Pedanova E.K., Doga A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/947

Полипоидная хориоидальная васкулопатия считается редким подтипом неоваскулярной формы возрастной макулярной дегенерации, специфическим признаком которой является хориоидальная ветвящаяся сосудистая сеть с аневризматическими расширениями на ее окончаниях (полипами), диагностировать которые стало возможным благодаря индоцианин-зеленой ангиографии. От типичной ВМД полипоидную васкулопатию отличают некоторые офтальмоскопические проявления и данные диагностических методов исследования, таких как ОКТ с возможностью визуализации хориоидеи, ОКТ-ангиография и ангиография сосудов глазного дна, а также различия в экспрессии VEGF-фактора. Несмотря на разный ответ на антиангиогенную терапию, наличие патологической неоваскуляризации объясняет необходимость применения анти-VEGF молекул для лечения обеих форм ВМД. В статье приводится обзор современных литературных данных, посвященных методам лечения полипоидной хориоидальной васкулопатии: монотерапии анти-VEGF препаратами, фотодинамической монотерапии, а также их комбинации. Основной акцент сделан на результаты проведенных мультицентровых рандомизированных клинических исследований с большим количеством пациентов по оценке эффективности Ранибизумаба и Афлиберцепта (EVEREST 2 и PLANET). В статье описаны краткосрочные и долгосрочные результаты лечения с учетом применяемых режимов дозирования, количества требуемых инъекций и необходимости комбинации монотерапии анти-VEGF препаратами с фотодинамической терапией. Результаты рандомизированных клинических исследований предоставляют доказательную базу, которая может быть использована клиническими специалистами для выбора оптимальной тактики лечения полипоидной хориоидальной васкулопатии.

Polypoidal choroidal vasculopathy (PCV) is a rare subtype of neovascular age-related macular degeneration (AMD), its specific features are abnormal branching vascular network with aneurysmal dilatations (polyps), it can be diagnosed in indocyanine green angiography. PCV differs from typical AMD by some ophthalmoscopic manifestations, multimodal imaging data as angiography, OCT with the ability to visualize the choroid, OCT-angiography and expression of VEGF. Despite the different response to antiangiogenic therapy, the presence of pathological neovascularization requires anti-VEGF treatment for both AMD types. In this review, we summarize the latest literature data on the treatment of polyphoidal choroidal vasculopathy: anti-VEGF monotherapy, photodynamic monotherapy, and their combinations. Special attention is paid to the results of multicenter randomized clinical trials with a large number of patients evaluating efficacy of Ranibizumab and Aflibercept (EVEREST 2 and PLANET). The short-term and long-term results of treatment are presented, taking into account the dosing regimens, the number of required injections and the requirement for a combination of anti-VEGF monotherapy with photodynamic therapy. The results of randomized clinical trial are providing high level evidence to guide clinical specialists in choosing the most appropriate therapy for PCV.

полипоидная хориоидальная васкулопатиявозрастная макулярная дегенерацияранибизумабафлиберцептфотодинамическая терапиярежимы дозированияpolypoid choroidal vasculopathyage-related macular degenerationRanibizumabAfliberceptphotodynamic therapydosing regimensReferencesSpaide R.F., Yannuzzi L.A., Slakter J.S., Sorenson J., Orlach D.A. Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy. Retina. 1995;15(2):100–110.Spaide R.F., Yannuzzi L.A., Slakter J.S., Sorenson J., Orlach D.A. Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy. Retina. 1995;15(2):100–110.Honda S., Matsumiya W., Negi A. Polypoidal choroidal vasculopathy: clinical features and genetic predisposition. Ophthalmologica. 2014;231(2):59–74. DOI: 10.1159/000355488Honda S., Matsumiya W., Negi A. Polypoidal choroidal vasculopathy: clinical features and genetic predisposition. Ophthalmologica. 2014;231(2):59–74. DOI: 10.1159/000355488Hatz K., Prünte C. Polypoidal choroidal vasculopathy in Caucasian patients with presumed neovascular age-related macular degeneration and poor ranibizumab response Br J Ophthalmol. 2014 Feb;98(2):188–194. DOI: 10.1136/bjophthalmol-2013-303444Hatz K., Prünte C. Polypoidal choroidal vasculopathy in Caucasian patients with presumed neovascular age-related macular degeneration and poor ranibizumab response Br J Ophthalmol. 2014 Feb;98(2):188–194. DOI: 10.1136/bjophthalmol-2013-303444 4. Yannuzzi L., Sorenson J., Spaide R.F., Lipson B. Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina. 1990;10(1):1–8.Yannuzzi L., Sorenson J., Spaide R.F., Lipson B. Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina. 1990;10(1):1–8.Stern R.M., Zakov Z.N., Zegarra H., Gutman F.A. Multiple recurrent serosanguineous retinal pigment epithelial detachments in black women. Am J Ophthalmol. 1985 Oct 15;100(4):560–569.Stern R.M., Zakov Z.N., Zegarra H., Gutman F.A. Multiple recurrent serosanguineous retinal pigment epithelial detachments in black women. Am J Ophthalmol. 1985 Oct 15;100(4):560–569.Kleiner R.C., Brucker A.J., Johnston R.L. The posterior uveal bleeding syndrome. Retina. 1990;10(1):9–17.Kleiner R.C., Brucker A.J., Johnston R.L. The posterior uveal bleeding syndrome. Retina. 1990;10(1):9–17.Yannuzzi L.A., Ciardella A., Spaide R.F., Rabb M., Freund K.B., Orlock D.A. The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy. Arch Ophthalmol. 1997 Apr;115(4):478–85.Yannuzzi L.A., Ciardella A., Spaide R.F., Rabb M., Freund K.B., Orlock D.A. The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy. Arch Ophthalmol. 1997 Apr;115(4):478–85.Yannuzzi L.A., Wong D.W., Sforzolini B.S., Goldbaum M., Tang K.C., Spaide R.F., Freund K.B., Slakter J.S., Guyer D.R., Sorenson J.A., Fisher Y., Maberley D., Orlock D.A. Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration. Arch Ophthalmol. 1999 Nov;117(11):1503–1510.Yannuzzi L.A., Wong D.W., Sforzolini B.S., Goldbaum M., Tang K.C., Spaide R.F., Freund K.B., Slakter J.S., Guyer D.R., Sorenson J.A., Fisher Y., Maberley D., Orlock D.A. Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration. Arch Ophthalmol. 1999 Nov;117(11):1503–1510.Lim T.H., Laude A., Tan C.S. Polypoidal choroidal vasculopathy: an angiographic discussion. Eye (Lond). 2010 Mar;24(3):483–490. DOI: 10.1038/eye.2009.323Lim T.H., Laude A., Tan C.S. Polypoidal choroidal vasculopathy: an angiographic discussion. Eye (Lond). 2010 Mar;24(3):483–490. DOI: 10.1038/eye.2009.323Khan S., Engelbert M., Imamura Y., Freund K.B. Polypoidal choroidal vasculopathy: simultaneous indocyanine green angiography and eye-tracked spectral domain optical coherence tomography findings. Retina. 2012 Jun;32(6):1057–1068. DOI: 10.1097/IAE.0b013e31823beb14Khan S., Engelbert M., Imamura Y., Freund K.B. Polypoidal choroidal vasculopathy: simultaneous indocyanine green angiography and eye-tracked spectral domain optical coherence tomography findings. Retina. 2012 Jun;32(6):1057–1068. DOI: 10.1097/IAE.0b013e31823beb14Rosa R.H. Jr, Davis J.L., Eifrig C.W. Clinicopathologic Correlation of Idiopathic Polypoidal Choroidal Vasculopathy. Arch Ophthalmol. 2002 Apr;120(4):502–508.Rosa R.H. Jr, Davis J.L., Eifrig C.W. Clinicopathologic Correlation of Idiopathic Polypoidal Choroidal Vasculopathy. Arch Ophthalmol. 2002 Apr;120(4):502–508.Nakashizuka H., Mitsumata M., Okisaka S., Shimada H., Kawamura A., Mori R., Yuzawa M. Clinicopathologic findings in polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci. 2008 Nov;49(11):4729–4737. DOI: 10.1167/iovs.08-2134Nakashizuka H., Mitsumata M., Okisaka S., Shimada H., Kawamura A., Mori R., Yuzawa M. Clinicopathologic findings in polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci. 2008 Nov;49(11):4729–4737. DOI: 10.1167/iovs.08-2134Kawamura A., Yuzawa M., Mori R., Haruyama M., Tanaka K. Indocyanine green angiographic and optical coherence tomographic findings support classification of polypoidal choroidal vasculopathy into two types. Acta Ophthalmol. 2013 Sep;91(6):e474–e481. DOI: 10.1111/aos.12110Kawamura A., Yuzawa M., Mori R., Haruyama M., Tanaka K. Indocyanine green angiographic and optical coherence tomographic findings support classification of polypoidal choroidal vasculopathy into two types. Acta Ophthalmol. 2013 Sep;91(6):e474–e481. DOI: 10.1111/aos.12110Dansingani K.K., Gal-Or O., Sadda S.R., Yannuzzi L.A., Freund K.B. Understanding aneurysmal type 1 neovascularisation (polypoidal choroidal vasculopathy): a lesson in the taxonomy of “expanded spectra”. Clin Exp Ophthalmol. 2018 Mar;46(2):189– 200. DOI: 10.1111/ceo.13114Dansingani K.K., Gal-Or O., Sadda S.R., Yannuzzi L.A., Freund K.B. Understanding aneurysmal type 1 neovascularisation (polypoidal choroidal vasculopathy): a lesson in the taxonomy of “expanded spectra”. Clin Exp Ophthalmol. 2018 Mar;46(2):189– 200. DOI: 10.1111/ceo.13114Imamura Y., Engelbert M., Iida T., Freund K.B., Yannuzzi L.A. Polypoidal choroidal vasculopathy: a review. Surv Ophthalmol. 2010 Nov-Dec;55(6):501–515. DOI: 10.1016/j.survophthal.2010.03.004Imamura Y., Engelbert M., Iida T., Freund K.B., Yannuzzi L.A. Polypoidal choroidal vasculopathy: a review. Surv Ophthalmol. 2010 Nov-Dec;55(6):501–515. DOI: 10.1016/j.survophthal.2010.03.004Chung S.E., Kang S.W., Lee J.H., Kim Y.T. Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration. Ophthalmology. 2011 May;118(5):840–845. DOI: 10.1016/j.ophtha.2010.09.012Chung S.E., Kang S.W., Lee J.H., Kim Y.T. Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration. Ophthalmology. 2011 May;118(5):840–845. DOI: 10.1016/j.ophtha.2010.09.012Laude A., Cackett P.D., Vithana E.N., Yeo I.Y., Wong D., Koh A.H., Wong T.Y., Aung T. Polypoidal choroidal vasculopathy and neovascular age-related macular degeneration: same or different disease? Prog Retin Eye Res. 2010 Jan;29(1):19-29. doi: 10.1016/j.preteyeres.2009.10.001.Laude A., Cackett P.D., Vithana E.N., Yeo I.Y., Wong D., Koh A.H., Wong T.Y., Aung T. Polypoidal choroidal vasculopathy and neovascular age-related macular degeneration: same or different disease? Prog Retin Eye Res. 2010 Jan;29(1):19-29. doi: 10.1016/j.preteyeres.2009.10.001.Tong J.P., Chan W.M., Liu D.T., Lai T.Y., Choy K.W., Pang C.P., Lam D.S. Aqueous humor levels of vascular endothelial growth factor and pigment epithelium-derived factor in polypoidal choroidal vasculopathy and choroidal neovascularization. Am J Ophthalmol. 2006;141:456‒462.Tong J.P., Chan W.M., Liu D.T., Lai T.Y., Choy K.W., Pang C.P., Lam D.S. Aqueous humor levels of vascular endothelial growth factor and pigment epithelium-derived factor in polypoidal choroidal vasculopathy and choroidal neovascularization. Am J Ophthalmol. 2006;141:456‒462.Matsuoka M., Ogata N., Otsuji T., Nishimura T., Takahashi K., Matsumura M. Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathy. Br J Ophthalmol. 2004 Jun;88(6):809–815.Matsuoka M., Ogata N., Otsuji T., Nishimura T., Takahashi K., Matsumura M. Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathy. Br J Ophthalmol. 2004 Jun;88(6):809–815.Lee M.Y., Lee W.K., Baek J., Kwon O.W., Lee J.H. Photodynamic therapy versus combination therapy in polypoidal choroidal vasculopathy: changes of aqueous vascular endothelial growth factor. Am J Ophthalmol. 2013 Aug;156(2):343–348. DOI: 10.1016/j.ajo.2013.04.001Lee M.Y., Lee W.K., Baek J., Kwon O.W., Lee J.H. Photodynamic therapy versus combination therapy in polypoidal choroidal vasculopathy: changes of aqueous vascular endothelial growth factor. Am J Ophthalmol. 2013 Aug;156(2):343–348. DOI: 10.1016/j.ajo.2013.04.001Cheung C.M.G., Lai T.Y.Y., Ruamviboonsuk P., Chen S.J., Chen Y., Freund K.B., Gomi F., Koh A.H., Lee W.K., Wong T.Y. Polypoidal Choroidal Vasculopathy: Definition, Pathogenesis, Diagnosis, and Management. Ophthalmology. 2018 May;125(5):708–724. DOI: 10.1016/j.ophtha.2017.11.019Cheung C.M.G., Lai T.Y.Y., Ruamviboonsuk P., Chen S.J., Chen Y., Freund K.B., Gomi F., Koh A.H., Lee W.K., Wong T.Y. Polypoidal Choroidal Vasculopathy: Definition, Pathogenesis, Diagnosis, and Management. Ophthalmology. 2018 May;125(5):708–724. DOI: 10.1016/j.ophtha.2017.11.019Mayorova A.M., Doga A.V., Pedanova E.K., Volodin P.L. Autofluorescence of the fundus in the complex diagnosis of polypoid choroidal vasculopathy. Modern technologies in ophthalmology = Sovremennye tekhnologii v oftal’mologii. 2017;4:141–143 (In Russ.).Майорова А.М., Дога А.В., Педанова Е.К., Володин П.Л. Аутофлюоресценция глазного дна в комплексной диагностике полипоидной хориоидальной васкулопатии. Современные технологии в офтальмологии. 2017;4:141–143.Panova I.E., Shaimov T.B., Shaimova V.A. Non-Invasive Diagnosis of Polypoidal Choroidal Vasculopathy as a Variant of the Course of Age-Related Macular Degeneration. Ophthalmology in Russia = Ophthal’mologiya. 2018;15(2S):273–280 (In Russ.). DOI: 10.18008/1816-5095-2018-2S-273-280Панова И.Е., Шаимов Т.Б., Шаимова В.А. Неинвазивная диагностика полипоидной хориоидальной васкулопатии как варианта течения возрастной макулярной дегенерации Офтальмология. 2018;15(2S):273–280. DOI: 10.18008/1816-5095-2018-2S-273-280Tan C.S., Ngo W.K., Chen J.P., Tan N.W., Lim T.H.; EVEREST Study Group. EVEREST study report 2: imaging and grading protocol, and baseline characteristics of a randomised controlled trial of polypoidal choroidal vasculopathy Br J Ophthalmol. 2015 May;99(5):624–628. DOI: 10.1136/bjophthalmol-2014-305674Tan C.S., Ngo W.K., Chen J.P., Tan N.W., Lim T.H.; EVEREST Study Group. EVEREST study report 2: imaging and grading protocol, and baseline characteristics of a randomised controlled trial of polypoidal choroidal vasculopathy Br J Ophthalmol. 2015 May;99(5):624–628. DOI: 10.1136/bjophthalmol-2014-305674Shaimov T.B., Panova I.E., Shaimova V.A. Indocyanine green angiography in the algorithm of diagnostics of polypoidal chrioidal vasculopathy in age-related macular degeneration. Practical medicine = Prakticheskaya meditsina. 2017;2(9,110):253–258 (In Russ.).Шаимов Т.Б., Панова И.Е., Шаимова В.А. Ангиография с индоцианин-зеленым в алгоритме диагностики полипоидной хориоидальной васкулопатии при возрастной макулярной дегенерации. Практическая медицина. 2017;2(9,110):253–258.Gomi F., Ohji M., Sayanagi K., Sawa M., Sakaguchi H., Oshima Y., Ikuno Y., Tano Y. One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients. Ophthalmology. 2008;115(1):141e146 DOI: 10.1016/j.ophtha.2007.02.031Gomi F., Ohji M., Sayanagi K., Sawa M., Sakaguchi H., Oshima Y., Ikuno Y., Tano Y. One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients. Ophthalmology. 2008;115(1):141e146 DOI: 10.1016/j.ophtha.2007.02.031Akaza E., Yuzawa M., Mori R. Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy. Jpn J Ophthalmol. 2011 Jan;55(1):39–44. DOI: 10.1007/s10384-010-0886-xAkaza E., Yuzawa M., Mori R. Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy. Jpn J Ophthalmol. 2011 Jan;55(1):39–44. DOI: 10.1007/s10384-010-0886-xWong C.W., Cheung C.M., Mathur R., Li X., Chan C.M., Yeo I., Wong E., Lee S.Y., Wong D., Wong T.Y. Three-year results of polypoidal choroidal vasculopathy treated with photodynamic therapy: retrospective study and systematic review. Retina. 2015 Aug;35(8):1577–1593. DOI: 10.1097/IAE.0000000000000499Wong C.W., Cheung C.M., Mathur R., Li X., Chan C.M., Yeo I., Wong E., Lee S.Y., Wong D., Wong T.Y. Three-year results of polypoidal choroidal vasculopathy treated with photodynamic therapy: retrospective study and systematic review. Retina. 2015 Aug;35(8):1577–1593. DOI: 10.1097/IAE.0000000000000499Tsuchiya D., Yamamoto T., Kawasaki R., Yamashita H. Two-year visual outcomes after photodynamic therapy in age-related macular degeneration patients with or without polypoidal choroidal vasculopathy lesions. Retina. 2009 JulAug;29(7):960–955. DOI: 10.1097/IAE.0b013e3181a3b7c5Tsuchiya D., Yamamoto T., Kawasaki R., Yamashita H. Two-year visual outcomes after photodynamic therapy in age-related macular degeneration patients with or without polypoidal choroidal vasculopathy lesions. Retina. 2009 JulAug;29(7):960–955. DOI: 10.1097/IAE.0b013e3181a3b7c5Gomi F., Sawa M., Sakaguchi H., Tsujikawa M., Oshima Y., Kamei M., Tano Y. Efficacy of intravitreal bevacizumab for polypoidal choroidal vasculopathy. Br J Ophthalmol. 2008 Jan;92(1):70–73.Gomi F., Sawa M., Sakaguchi H., Tsujikawa M., Oshima Y., Kamei M., Tano Y. Efficacy of intravitreal bevacizumab for polypoidal choroidal vasculopathy. Br J Ophthalmol. 2008 Jan;92(1):70–73.Lai T.Y., Lee G.K., Luk F.O., Lam D.S. Intravitreal ranibizumab with or without photodynamic therapy for the treatment of symptomatic polypoidal choroidal vasculopathy. Retina. 2011 Sep;31(8):1581–1588. DOI: 10.1097/IAE.0b013e31820d3f3fLai T.Y., Lee G.K., Luk F.O., Lam D.S. Intravitreal ranibizumab with or without photodynamic therapy for the treatment of symptomatic polypoidal choroidal vasculopathy. Retina. 2011 Sep;31(8):1581–1588. DOI: 10.1097/IAE.0b013e31820d3f3fOgino K., Tsujikawa A., Yamashiro K., Ooto S., Oishi A., Nakata I., Miyake M., Yoshimura N. Intravitreal injection of ranibizumab for recovery of macular function in eyes with subfoveal polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci. 2013 May 1;54(5):3771–3779. DOI: 10.1167/iovs.12-11494Ogino K., Tsujikawa A., Yamashiro K., Ooto S., Oishi A., Nakata I., Miyake M., Yoshimura N. Intravitreal injection of ranibizumab for recovery of macular function in eyes with subfoveal polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci. 2013 May 1;54(5):3771–3779. DOI: 10.1167/iovs.12-11494Kang H.M., Koh H.J. Long-term visual outcome and prognostic factors after intravitreal ranibizumab injections for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2013 Oct;156(4):652–660. DOI: 10.1016/j.ajo.2013.05.038Kang H.M., Koh H.J. Long-term visual outcome and prognostic factors after intravitreal ranibizumab injections for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2013 Oct;156(4):652–660. DOI: 10.1016/j.ajo.2013.05.038Kokame G.T., Yeung L., Teramoto K., Lai J.C., Wee R. Polypoidal choroidal vasculopathy exudation and hemorrhage: results of monthly ranibizumab therapy at one year. Ophthalmologica. 2014;231(2):94–102. DOI: 10.1159/000354072Kokame G.T., Yeung L., Teramoto K., Lai J.C., Wee R. Polypoidal choroidal vasculopathy exudation and hemorrhage: results of monthly ranibizumab therapy at one year. Ophthalmologica. 2014;231(2):94–102. DOI: 10.1159/000354072Oishi A., Kojima H., Mandai M., Honda S., Matsuoka T., Oh H., Kita M., Nagai T., Fujihara M., Bessho N., Uenishi M., Kurimoto Y., Negi A. Comparison of the effect of ranibizumab and verteporfin for polypoidal choroidal vasculopathy: 12-month LAPTOP study results. Am J Ophthalmol. 2013 Oct;156(4):644–651. DOI: 10.1016/j. ajo.2013.05.024Oishi A., Kojima H., Mandai M., Honda S., Matsuoka T., Oh H., Kita M., Nagai T., Fujihara M., Bessho N., Uenishi M., Kurimoto Y., Negi A. Comparison of the effect of ranibizumab and verteporfin for polypoidal choroidal vasculopathy: 12-month LAPTOP study results. Am J Ophthalmol. 2013 Oct;156(4):644–651. DOI: 10.1016/j. ajo.2013.05.024Oishi A., Miyamoto N., Mandai M., Honda S., Matsuoka T., Oh H., Kita M., Nagai T., Bessho N., Uenishi M., Kurimoto Y., Negi A. LAPTOP study: a 24-month trial of verteporfin versus ranibizumab for polypoidal choroidal vasculopathy. Ophthalmology. 2014 May;121(5):1151–1152. DOI: 10.1016/j. ophtha.2013.12.037Oishi A., Miyamoto N., Mandai M., Honda S., Matsuoka T., Oh H., Kita M., Nagai T., Bessho N., Uenishi M., Kurimoto Y., Negi A. LAPTOP study: a 24-month trial of verteporfin versus ranibizumab for polypoidal choroidal vasculopathy. Ophthalmology. 2014 May;121(5):1151–1152. DOI: 10.1016/j. ophtha.2013.12.037Koh A., Lee W.K., Chen L.J., Chen S.J., Hashad Y., Kim H., Lai T.Y., Pilz S., Ruamviboonsuk P., Tokaji E., Weisberger A., Lim T.H. EVEREST study: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina. 2012 Sep;32(8):1453–1464.Koh A., Lee W.K., Chen L.J., Chen S.J., Hashad Y., Kim H., Lai T.Y., Pilz S., Ruamviboonsuk P., Tokaji E., Weisberger A., Lim T.H. EVEREST study: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina. 2012 Sep;32(8):1453–1464.Ogura Y., Terasaki H., Gomi F., Yuzawa M., Iida T., Honda M., Nishijo K., Sowade O., Komori T., Schmidt-Erfurth U., Simader C., Chong V. Efficacy and safety of intravitreal aflibercept injection in wet age-related macular degeneration: outcomes in the Japanese subgroup of the VIEW 2 study. Br J Ophthalmol. 2015 Jan;99(1):92– 97. DOI: 10.1136/bjophthalmol-2014-305076Ogura Y., Terasaki H., Gomi F., Yuzawa M., Iida T., Honda M., Nishijo K., Sowade O., Komori T., Schmidt-Erfurth U., Simader C., Chong V. Efficacy and safety of intravitreal aflibercept injection in wet age-related macular degeneration: outcomes in the Japanese subgroup of the VIEW 2 study. Br J Ophthalmol. 2015 Jan;99(1):92– 97. DOI: 10.1136/bjophthalmol-2014-305076Yamamoto A., Okada A.A., Kano M., Koizumi H., Saito M., Maruko I., Sekiryu T., Iida T. One-year results of intravitreal aflibercept for polypoidal choroidal vasculopathy. Ophthalmology. 2015 Sep;122(9):1866–1872. DOI: 10.1016/j. ophtha.2015.05.024Yamamoto A., Okada A.A., Kano M., Koizumi H., Saito M., Maruko I., Sekiryu T., Iida T. One-year results of intravitreal aflibercept for polypoidal choroidal vasculopathy. Ophthalmology. 2015 Sep;122(9):1866–1872. DOI: 10.1016/j. ophtha.2015.05.024Oishi A., Tsujikawa A., Yamashiro K., Ooto S., Tamura H., Nakanishi H., UedaArakawa N., Miyake M., Akagi-Kurashige Y., Hata M., Yoshikawa M., Kuroda Y., Takahashi A., Yoshimura N. One-year result of aflibercept treatment on age-related macular degeneration and predictive factors for visual outcome. Am J Ophthalmol. 2015 May;159(5):853–860.e1. DOI: 10.1016/j.ajo.2015.01.018Oishi A., Tsujikawa A., Yamashiro K., Ooto S., Tamura H., Nakanishi H., UedaArakawa N., Miyake M., Akagi-Kurashige Y., Hata M., Yoshikawa M., Kuroda Y., Takahashi A., Yoshimura N. One-year result of aflibercept treatment on age-related macular degeneration and predictive factors for visual outcome. Am J Ophthalmol. 2015 May;159(5):853–860.e1. DOI: 10.1016/j.ajo.2015.01.018Inoue M., Yamane S., Taoka R., Arakawa A., Kadonosono K. Aflibercept for polypoidal choroidal vasculopathy: as needed versus fixed interval dosing. Retina. 2016 Aug;36(8):1527–1534. DOI: 10.1097/IAE.0000000000000933Inoue M., Yamane S., Taoka R., Arakawa A., Kadonosono K. Aflibercept for polypoidal choroidal vasculopathy: as needed versus fixed interval dosing. Retina. 2016 Aug;36(8):1527–1534. DOI: 10.1097/IAE.0000000000000933Arakawa A., Inoue M., Sato S., Yamane S., Kadonosono K. Efficacy of intravitreal aflibercept injections for Japanese patients with polypoidal choroidal vasculopathy. Clin Ophthalmol. 2017 Apr 27;11:797–802. DOI: 10.2147/OPTH.S129164Arakawa A., Inoue M., Sato S., Yamane S., Kadonosono K. Efficacy of intravitreal aflibercept injections for Japanese patients with polypoidal choroidal vasculopathy. Clin Ophthalmol. 2017 Apr 27;11:797–802. DOI: 10.2147/OPTH.S129164Wolff B., Vasseur V., Cahuzac A., Coscas F., Castelnovo L., Favard C., Michel G., Français C., Salomon L., Mauget-Faÿsse M. Aflibercept Treatment in Polypoidal Choroidal Vasculopathy: Results of a Prospective Study in a Caucasian Population. Ophthalmologica. 2018;240(4):208–212. DOI: 10.1159/000488808Wolff B., Vasseur V., Cahuzac A., Coscas F., Castelnovo L., Favard C., Michel G., Français C., Salomon L., Mauget-Faÿsse M. Aflibercept Treatment in Polypoidal Choroidal Vasculopathy: Results of a Prospective Study in a Caucasian Population. Ophthalmologica. 2018;240(4):208–212. DOI: 10.1159/000488808Gomi F., Sawa M., Wakabayashi T., Sasamoto Y., Suzuki M., Tsujikawa M. Efficacy of intravitreal bevacizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2010 Jul;150(1):48–54.e1. DOI: 10.1016/j.ajo.2010.02.008Gomi F., Sawa M., Wakabayashi T., Sasamoto Y., Suzuki M., Tsujikawa M. Efficacy of intravitreal bevacizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2010 Jul;150(1):48–54.e1. DOI: 10.1016/j.ajo.2010.02.008Tomita K., Tsujikawa A., Yamashiro K., Ooto S., Tamura H., Otani A., Nakayama Y., Yoshimura N. Treatment of polypoidal choroidal vasculopathy with photodynamic therapy combined with intravitreal injections of ranibizumab. Am J Ophthalmol. 2012 Jan;153(1):68–80.e1. DOI: 10.1016/j.ajo.2011.07.001Tomita K., Tsujikawa A., Yamashiro K., Ooto S., Tamura H., Otani A., Nakayama Y., Yoshimura N. Treatment of polypoidal choroidal vasculopathy with photodynamic therapy combined with intravitreal injections of ranibizumab. Am J Ophthalmol. 2012 Jan;153(1):68–80.e1. DOI: 10.1016/j.ajo.2011.07.001Sato T., Kishi S., Matsumoto H., Mukai R. Comparisons of outcomes with different intervals between adjunctive ranibizumab and photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2013 Jul;156(1):95–105.e1. DOI: 10.1016/j.ajo.2013.02.006Sato T., Kishi S., Matsumoto H., Mukai R. Comparisons of outcomes with different intervals between adjunctive ranibizumab and photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2013 Jul;156(1):95–105.e1. DOI: 10.1016/j.ajo.2013.02.006Mayorova A.M., Doga A.V., Pedanova E.K. Clinical and functional outcomes of combined treatment for polypoidal choroidal vasculopathy. Practical medicine = Prakticheskaya meditsina. 2018.3;(114):114–117 (In Russ.).Майорова A.M., Дога А.В., Педанова Е.К. Клинико-функциональные результаты комбинированной терапии полипоидной хориоидальной васкулопатии. Практическая медицина. 2018.3;(114):114–117. [Mayorova A.M., Doga A.V., Pedanova E.K. Clinical and functional outcomes of combined treatment for polypoidal choroidal vasculopathy. Practical medicine = Prakticheskaya meditsina. 2018.3;(114):114–117 (In Russ.)].Koh A., Lai T.Y.Y., Takahashi K., Wong T.Y., Chen L.J., Ruamviboonsuk P., Tan C.S., Feller C., Margaron P., Lim T.H., Lee W.K. Efficacy and safety of ranibizumab with or without verteporfin photodynamic therapy for polypoidal choroidal vasculopathy: a randomized clinical trial. JAMA Ophthalmol. 2017 Nov 1;135(11):1206–1213. DOI: 10.1001/jamaophthalmol.2017.4030Koh A., Lai T.Y.Y., Takahashi K., Wong T.Y., Chen L.J., Ruamviboonsuk P., Tan C.S., Feller C., Margaron P., Lim T.H., Lee W.K. Efficacy and safety of ranibizumab with or without verteporfin photodynamic therapy for polypoidal choroidal vasculopathy: a randomized clinical trial. JAMA Ophthalmol. 2017 Nov 1;135(11):1206–1213. DOI: 10.1001/jamaophthalmol.2017.4030Lee W.K., Iida T., Ogura Y., Chen S.J., Wong T.Y., Mitchell P., Cheung G.C.M., Zhang Z., Leal S., Ishibashi T.; PLANET Investigators. Efficacy and Safety of Intravitreal Aflibercept for Polypoidal Choroidal Vasculopathy in the PLANET Study: A Randomized Clinical Trial. JAMA Ophthalmol. 2018;136(7):786–793. DOI: 10.1001/jamaophthalmol.2018.1804Lee W.K., Iida T., Ogura Y., Chen S.J., Wong T.Y., Mitchell P., Cheung G.C.M., Zhang Z., Leal S., Ishibashi T.; PLANET Investigators. Efficacy and Safety of Intravitreal Aflibercept for Polypoidal Choroidal Vasculopathy in the PLANET Study: A Randomized Clinical Trial. JAMA Ophthalmol. 2018;136(7):786–793. DOI: 10.1001/jamaophthalmol.2018.1804Wong T.Y., Ogura Y., Lee W.K., Iida T., Chen S.-J., Mitchell P., Gemmy Cheung C.M., Zhang Z., Leal S., Ishibashi T., On Behalf Of The Planet Investigators, Efficacy and Safety of Intravitreal Aflibercept for Polypoidal Choroidal Vasculopathy: 2-Year Results of the PLANET Study, American Journal of Ophthalmology. (2019), Publication stage: In Press Accepted Manuscript Published online: March 5, 2019. DOI: 10.1016/j.ajo.2019.02.027Wong T.Y., Ogura Y., Lee W.K., Iida T., Chen S.-J., Mitchell P., Gemmy Cheung C.M., Zhang Z., Leal S., Ishibashi T., On Behalf Of The Planet Investigators, Efficacy and Safety of Intravitreal Aflibercept for Polypoidal Choroidal Vasculopathy: 2-Year Results of the PLANET Study, American Journal of Ophthalmology. (2019), Publication stage: In Press Accepted Manuscript Published online: March 5, 2019. DOI: 10.1016/j.ajo.2019.02.027Wong T.Y., Ogura Y., Lee W.K., Iida T., Chen S.-J., Mitchell P., Gemmy Cheung C.M., Zhang Z., Leal S., Ishibashi T., On Behalf Of The Planet Investigators, Efficacy and Safety of Intravitreal Aflibercept for Polypoidal Choroidal Vasculopathy: 2-Year Results of the PLANET Study, American Journal of Ophthalmology. (2019), Publication stage: In Press Accepted Manuscript Published online: March 5, 2019. DOI: 10.1016/j.ajo.2019.02.027

The authors declare that there are no conflicts of interest present.