Photodynamic therapy in combination with ranibizumab versus ranibizumab monotherapy for polypoidal choroidal vasculopathy: A systematic review and meta-analysis

Polypoidal choroidal vasculopathy (PCV) is usually regarded as a subtype of choroidal neovascularization (CNV) that is secondary to age-related macular degeneration (AMD) characterized by choroidal vessel branching, ending in polypoidal lesions. Despite their close association, PCV and neovascular AMD have shown differences, especially regarding patients’ treatment response. Currently, antivascular endothelial growth factor (anti-VEGF) drugs, such as ranibizumab, bevacizumab and aflibercept, have demonstrated their efficacy in CNV patients. However, in PCV, anti-VEGF treatments have shown inconclusive results. Many genetic polymorphisms have been associated with a variable response in exudative/wet AMD patients. Thus, the aim of this study is to explore the genetic variants affecting anti-VEGF drug response in PCV patients. In this regard, we performed a systematic review and meta-analysis. We found four variants (CFH I62V, CFH Y402H, ARMS2 A69S, and HTRA1-62A/G) that have been significantly related to response. Among them, the ARMS2 A69S variant is assessed in our meta-analysis. In conclusion, in order to implement anti-VEGF pharmacogenetics in clinical routines, further studies should be performed, distinguishing physio-pathogenic circumstances between PCV and exudative AMD and the combined effect on treatment response of different genetic variants.

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Combined photodynamic therapy and ranibizumab for polypoidal choroidal vasculopathy: a 2-year result and systematic review

International Journal of Ophthalmology ◽

10.18240/ijo.2017.03.14 ◽

2017 ◽

Keyword(s):

Systematic Review ◽

Photodynamic Therapy ◽

Polypoidal Choroidal Vasculopathy ◽

Choroidal Vasculopathy

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The Efficacy of Conbercept in Polypoidal Choroidal Vasculopathy: A Systematic Review

Journal of Ophthalmology ◽

10.1155/2020/4924053 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Yimin Wang ◽

Mengxi Shen ◽

Jinwei Cheng ◽

Xiaodong Sun ◽

Peter K. Kaiser

Keyword(s):

Systematic Review ◽

Polypoidal Choroidal Vasculopathy ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Random Effect ◽

Fixed Effect Model ◽

Age Related Macular Degeneration ◽

Age Related ◽

Significant Difference ◽

Choroidal Vasculopathy

Topic. The aim of this study is to evaluate the efficacy of conbercept in PCV, which will optimize the management for PCV patients. Clinical Relevance. The use of antivascular endothelial growth factor (VEGF) therapy in polypoidal choroidal vasculopathy (PCV), a subtype of neovascular age-related macular degeneration (nAMD), has been well established in randomized clinical trials. This meta-analysis has evaluated the efficacy of a novel anti-VEGF agent, conbercept, in the management of PCV using ranibizumab and aflibercept as the reference agents. Methods. Thirty studies with 1308 eyes were identified and included in this study. The primary outcome measures were best-corrected visual acuity (BCVA), and secondary outcomes were optical coherence tomography characteristics and polyp regression rates. The pooled results were calculated by the random-effect or fixed-effect model according to the heterogeneity of the data. Results. Despite a large standard deviation in means (SMD) improvement for BCVA and central retinal thickness (CRT) in the conbercept group, there was no statistically significant difference in the other outcomes compared to ranibizumab and aflibercept. However, there was a greater polyp regression rate in the conbercept group at 12 months. Conclusions. This systematic review indicates that conbercept may achieve similar BCVA and CRT improvements as ranibizumab and aflibercept, with a superior rate of polyp regression at 12 months.

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