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This research assesses the long-term outcomes of intravitreal aflibercept therapy in patients with polypoidal choroidal vasculopathy.

March 30, 2026Open Access

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

Key Points

This research assesses the long-term outcomes of intravitreal aflibercept therapy in patients with polypoidal choroidal vasculopathy.
Non-interventional cohort study of 72 patients from the PLANET study
Data collection at ~6 years post-initiation of treatment
Measured best-corrected visual acuity, optical coherence tomography, and adverse events.
Mean BCVA improved by 14.6 letters at 2 years but declined to baseline by 6 years
45.8% had BCVA ≥ 69 ETDRS letters at year 6, while 23.6% had < 36 letters
Polypoidal lesions decreased from 69.4% at year 2 to 29.2% at year 6.

Abstract

The PLANET study demonstrated that intravitreal aflibercept 2 mg injection (IAI) monotherapy was non-inferior to IAI with rescue photodynamic therapy (PDT) for polypoidal choroidal vasculopathy (PCV) at 2 years. This follow-up study assessed the long-term outcomes 6 years after initiation of IAI therapy in the PLANET cohort. This was a non-interventional cohort study of 72 patients with PCV from six international sites who originally completed the PLANET study. Outcomes were assessed during a recall visit at ~6 years from PLANET enrollment. Data collected included best-corrected visual acuity (BCVA), optical coherence tomography, treatment exposure, and adverse events. Patients were treated according to standard of care after exiting from the PLANET study. Of 72 participants, 32 were randomized to IAI monotherapy and 40 to IAI with rescue PDT. Of those randomized to IAI with rescue PDT, 11 (15.2%) received rescue PDT during the entire study period over 6 years. Mean ± standard deviation (SD) BCVA improved by 14.6 ± 10.3 letters at 2 years but declined to baseline by 6 years (−0.3 ± 21.8 letters). At year 6, 45.8% of eyes had BCVA ≥ 69 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, while 23.6% had < 36 ETDRS letters. Polypoidal lesions were present in 69.4% at year 2 versus 29.2% at year 6. Patients received a mean ± SD of 10.2 ± 2.9 anti-vascular endothelial growth factor (anti-VEGF) injections between years 2–6. Outcomes were better in reimbursed versus non-reimbursed regions. Multivariable analysis showed that younger age and better mean BCVA at year 2 predicted more favorable long-term vision. PDT received at any time was not associated with overall mean BCVA at year 6, although it was associated with a lower risk of ≥ 15-letter loss. At 6 years, initial visual gains from aflibercept therapy were not maintained; however, nearly half of the eyes had BCVA ≥ 69 letters, and a large proportion achieved polypoidal lesion regression. ClinicalTrials.gov identifier, NCT002120950.

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