Comparing Intravitreal Aflibercept Monotherapy vs Aflibercept Combined With Reduced Fluence PDT in PCV Treatment
Polypoidal Choroidal Vasculopathy
About this trial
This is an interventional treatment trial for Polypoidal Choroidal Vasculopathy
Eligibility Criteria
Inclusion Criteria:
- Patients aged over 50 years old at the time of informed consent.
- Provide written informed consent.
- Willingness and ability to comply with all scheduled visits and study procedures.
- Confirmed diagnosis of symptomatic macular PCV based ICGA.
Activity of PCV confirmed by exudative activity involving the macula on OCT or Fluorescein Angiography (FA) or both.
- Presence of intra retinal or subretinal fluid/blood as seen on OCT
Treatment naïve
- NO previous treatment with intravitreal anti-VEGF agents, regardless of the indication
- NO previous thermal laser in the macular region, or verteporfin photodynamic therapy (vPDT), regardless of indication
- NO other previous treatment for neovascular AMD (nAMD), except oral supplements and traditional Chinese medicine
- An ETDRS BCVA of at least 4 letters (Snellen equivalent approximately 20/800 or better) in the study eye.
- Greatest Linear Dimension (GLD) of the total lesion area (BVN + polyps) <5400µm (~9 mucopolysaccharidoses (MPS) Disc Areas) as delineated by ICGA.
Exclusion Criteria: - Participant
- Medical condition that, in the opinion of the investigator, would preclude participation in the study (e.g. unstable medical status including blood pressure, cardiovascular disease, and glycemic control).
- Participation in an investigational trial within 30 days of enrollment which involves treatment with unapproved investigational drug.
- Known allergy to any component of the study drug.
- Blood pressure> 180/110 (systolic above 180 OR diastolic above 110 on repeated measurements). If blood pressure is brought below 180/110 by anti-hypertensive treatment, individual can become eligible.
- Myocardial infarction, other acute cardiac event requiring hospitalization, stroke, transient ischemic attack, or treatment for acute congestive heart failure within 4 months prior to randomization.
- Systemic anti-VEGF or pro-VEGF treatment within four months prior to randomization or anticipated use during the study.
- Amblyopia or blind in one eye Study Eye
- Eye with intra retinal or sub-retinal fluid due to other causes than PCV
- An ocular condition is present (other than PCV) that, in the opinion of the investigator, might affect intra or sub retinal fluid or alter visual acuity during the course of the study (e.g., Diabetic Macular Edema (DME), vein occlusion, uveitis or other ocular inflammatory disease, neovascular glaucoma, etc.)
- Substantial cataract that, in the opinion of the investigator, is likely to be decreasing visual acuity by more than three lines (i.e., cataract would be reducing acuity to worse than 20/40 if eye was otherwise normal).
- Any intraocular surgery within 1 month of enrollment
- Treatment with intra vitreal corticosteroids
- History of retinal detachment or surgery for retinal detachment
- History of vitrectomy
- History of macular hole
- Evidence of vitreomacular traction that may preclude resolution of macular edema > 4 disc areas of intra/sub retinal hemorrhage
- Aphakia
- Exam evidence of external ocular infection, including conjunctivitis, chalazion, or significant blepharitis
Other Eye
- Active intraocular inflammation
- History of uveitis
Sites / Locations
- Singapore National Eye CentreRecruiting
- National University HospitalRecruiting
- Tan Tock Seng HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Aflibercept + RF-PDT
Aflibercept + sham RF-PDT
Patients with symptomatic macular PCV (n=80) as confirmed by Indocyanine green Angiography(ICGA) will be treated with Aflibercept (dosage=2mg/0.05ml) through an intravitreal injection + RF-PDT ( 6mg/m2 intravenous infusion of Verteporfin followed by laser light at a dose rate of 25 Joules/cm2) at baseline. Aflibercept- 1st treatment (baseline) followed by minimum retreatment interval of 4 weeks (from Baseline to week 8) and then retreatment at intervals of 4 weeks pro re nata (PRN) retreatment( week 12-48). Primary endpoint at week 52. RF-PDT treatment at baseline followed by pro re nata (PRN) at 12 week intervals. At each visit, subjects will be assessed based on BCVA, ophthalmic examination and Optical Coherence Tomography (OCT)
Patients with symptomatic macular PCV (n=80) as confirmed by Indocyanine green Angiography(ICGA) will be treated with Aflibercept (dosage=2mg/0.05ml) through an intravitreal injection, at baseline. A minimum of 1 injection(baseline) followed by minimum pro re nata (PRN) retreatment interval of 4 weeks ( from baseline to week 8) and then a minimum of 4 weeks retreatment thereafter (week 12-48). Primary endpoint at week 52. Sham RF-PDT treatment at baseline followed by pro re nata (PRN) at 12 week intervals. At each visit, subjects will be assessed based on Best Corrected Visual Acuity (BCVA), ophthalmic examination and Optical Coherence Tomography (OCT)