Long-term effect of intravitreal aflibercept treatment on choroidal vascularity index in neovascular age-related macular degeneration.

Background: Our aim is to examine the effect of intravitreal aflibercept treatment on the choroidal vascularity index in eyes with neovascular age-related macular degeneration (nARMD) using the binarization method.

Methods: Included in the study were the 38 eyes of 38 patients diagnosed with nARMD and treated with intravitreal aflibercept at our clinic. The patients' 12-month records were reviewed retrospectively. Patients' choroidal thickness (CT) was measured at baseline, 3rd month, 6th month, and 12th month on EDI-OCT images. We calculated luminal area (LA), stromal area (SA), total choroidal area (TCA), and choroid vascular index (CVI) values using binarization.

Results: The mean age of the patients was 70,1 ± 8 years. The mean of injections over 12 months was 5.6 ± 2. Baseline values were CT 224 µm, LA 0,214 mm, SA 0,119mm, TCA 0,333 mm, and CVI 64% respectively. At the 3rd month, values were CT 223 µm, LA 0,212 mm, SA 0,121 mm, TCA 0,332 mm, and CVI 64%, respectively. The 6th-month values were CT 221 µm, LA 0,204 mm, SA 0,116 mm, TCA 0,320 mm, and CVI 64%, respectively, and 12-month values were CT 218 µm, LA 0,204 mm, SA 0,112 mm, TCA 0,318 mm, and CVI 64%, respectively. According to LogMAR, BCVA was 0.59 at baseline, 0.56 at 3 months, 0.52 at 6 months, and 0.51 at 12 months. At the end of month 12, we observed a statistically significant decrease in CT. No significant changes were observed in other parameters. When the number of injections was correlated with CVI, CT, and BCVA, a significant negative correlation was observed with CVI CONCLUSIONS: Aflibercept treatment reduces CT by affecting not only luminal but also stromal areas of the choroid in the long term but does not change the CVI. However, as the number of injections increases, CVI decreases.