Short-term focal macular electroretinogram of eyes treated by aflibercept & photodynamic therapy for polypoidal choroidal vasculopathy

Background: To compare short-term outcomes of intravitreal aflibercept injection (IAI) with or without initial photodynamic therapy (PDT) for polypoidal choroidal vasculopathy (PCV) using focal macular electroretinography (FMERG). Design: Observation case series. Methods: Twelve patients (6 males, 6 females; 12 eyes) with naïve PCV received 3 initial IAIs and a single session of PDT 3 days after the first IAI (combination group), and 13 patients (7 males, 6 females; 13 eyes) with naïve PCV received 3 initial IAIs only (IAI group) were retrospectively observed. Changes in visual acuity, central retinal thickness (CRT), central choroidal thickness (CCT), and FMERG parameters (FMERGs) were compared. Results: The combination group showed improved visual acuity after the second and third IAI (P = 0.040, 0.019, respectively); both groups showed reduced CRT after the first IAI (P < 0.01, each). Only the combination group showed reduced CCT after the third IAI (P = 0.031). The FMERGs of the IAI group showed improved amplitudes of a-waves after the third IAI (P = 0.026) and of b-waves after the first and third IAI (P = 0.034, < 0.01, respectively); the combination group did not show improvement. The implicit times of the a- and b-waves were not changed in either group. Conclusions: Combination therapy and IAI monotherapy each improved visual acuity and retinal structure to a similar degree; combination therapy reduced choroidal thickness but did not improve FMERGs in the short term.