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Six-Year Outcomes in Subjects with Polypoidal Choroidal Vasculopathy in the EVEREST II Study

Teo KYC 1 , Park KH 2 , Ngah NF 3 , Chen SJ 4 , Ruamviboonsuk P 5 , Mori R 6 Show all authors , Kondo N 7 , Lee WK 8 , Rajagopalan R 9 , Obata R 10 , Wong IYH 11 , Chee C 12 , Terasaki H 13 , Sekiryu T 14 , Chen SC 15 , Yanagi Y 1 , Honda S 16 , Lai TYY 17 , Cheung CMG 18

Affiliations 

  • 1 Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore
  • 2 Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  • 3 Hospital Selayang, Batu Caves, Selangor, Malaysia
  • 4 Department of Ophthalmology, Taipei Veterans General Hospital, School of Medicine, National Yang Ming Chiao Yung University, 201 Shih-Pai Road, Taipei, 112, Taiwan
  • 5 Department of Ophthalmology, College of Medicine, Rangsit University, Rajavithi Hospital, Bangkok, Thailand
  • 6 Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan
  • 7 Miyake Eye Hospital Ophthalmology, Ozone, Kita-ku, Nagoya City, Japan
  • 8 Nune Eye Hospital, Seoul, South Korea
  • 9 Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore, Singapore
  • 10 The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
  • 11 Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong
  • 12 National University Hospital, Singapore, Singapore
  • 13 Nagoya University Hospital, Nagoya City, Aichi, Japan
  • 14 Fukushima Medical University Hospital, Fukushima City, Fukushima, Japan
  • 15 Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
  • 16 Osaka Metropolitan University Hospital, Osaka City, Osaka, Japan
  • 17 Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong
  • 18 Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore. gemmy.cheung.c.m@singhealth.com.sg
Ophthalmol Ther, 2024 Apr;13(4):935-954.
PMID: 38308746 DOI: 10.1007/s40123-024-00888-0

Abstract

INTRODUCTION: The EVEREST II study previously reported that intravitreally administered ranibizumab (IVR) combined with photodynamic therapy (PDT) achieved superior visual gain and polypoidal lesion closure compared to IVR alone in patients with polypoidal choroidal vasculopathy (PCV). This follow-up study reports the long-term outcomes 6 years after initiation of the EVEREST II study.

METHODS: This is a non-interventional cohort study of 90 patients with PCV from 16 international trial sites who originally completed the EVEREST II study. The long-term outcomes were assessed during a recall visit at about 6 years from commencement of EVEREST II.

RESULTS: The monotherapy and combination groups contained 41 and 49 participants, respectively. The change in best-corrected visual acuity (BCVA) from baseline to year 6 was not different between the monotherapy and combination groups; - 7.4 ± 23.0 versus - 6.1 ± 22.4 letters, respectively. The combination group had greater central subfield thickness (CST) reduction compared to the monotherapy group at year 6 (- 179.9 vs - 74.2 µm, p = 0.011). Fewer eyes had subretinal fluid (SRF)/intraretinal fluid (IRF) in the combination versus monotherapy group at year 6 (35.4% vs 57.5%, p = 0.032). Factors associated with BCVA at year 6 include BCVA (year 2), CST (year 2), presence of SRF/IRF at year 2, and number of anti-VEGF treatments (years 2-6). Factors associated with presence of SRF/IRF at year 6 include combination arm (OR 0.45, p = 0.033), BCVA (year 2) (OR 1.53, p = 0.046), and presence of SRF/IRF (year 2) (OR 2.59, p = 0.042).

CONCLUSION: At 6 years following the EVEREST II study, one-third of participants still maintained good vision. As most participants continued to require treatment after exiting the initial trial, ongoing monitoring and re-treatment regardless of polypoidal lesion status are necessary in PCV.

TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT01846273.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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