Response of serous retinal pigment epithelial detachments to intravitreal aflibercept in polypoidal choroidal vasculopathy refractory to ranibizumab
A 79-year-old man presented with a large serous PED. Fluorescein angiography (FA) displayed an occult CNV, and indocyanine green (IA) images showed a PCV. At the initial visit, his best-corrected visual acuity (BCVA) was 2/20 oculus sinister (OS). Three monthly injections of ranibizumab slightly flattened the PED and reduced the subretinal fluid (SRF), but a recurrence developed. Three additional monthly injections of ranibizumab (total of six injections) did not improve the PED, and there was an increase of the highly reflective material beneath the outer surface of the RPE in the SD-OCT images.\nWe switched to aflibercept and, after one intravitreal injection, the PED was slightly flattened; two additional injections of aflibercept were given, which flattened the PED over the hyper-reflective material observed by SD-OCT. The BCVA remained at 2/20 OS ().