Combination therapy for PCV shows no significant visual benefit over monotherapy

Adding reduced-fluence photodynamic therapy (RF-PDT) to intravitreal aflibercept injections (IAI) did not provide a significant improvement in visual outcomes for patients with polypoidal choroidal vasculopathy (PCV) after 52 weeks, according to a study.

The study enrolled 60 participants, ≥ 50, with symptomatic macular PCV confirmed via indocyanine green angiography. Patients were randomly assigned to receive either RF-PDT plus IAI or IAI monotherapy, with follow-up at 52 weeks.

There was no significant difference in best-corrected visual acuity between the 2 groups at week 52, with a mean gain of 12.7 letters in the combination therapy arm versus 11.9 in the monotherapy arm (P = 0.82). However, at week 12, polypoidal lesion closure was significantly higher in the combination group (66.7%) compared to the monotherapy group (33.3%) (P = 0.02).

Despite these findings, the study was unable to establish a clear functional benefit of combination therapy due to its limited sample size.

Reference
Chong YJ, Teo KYC, Wong W, et al. Aflibercept With vs Without Reduced-Fluence Photodynamic Therapy for Polypoidal Choroidal Vasculopathy: A Randomized Clinical Trial. JAMA Ophthalmol. 2025;doi: 10.1001/jamaophthalmol.2025.0250. Epub ahead of print. PMID: 40146166.