Reply to comment on: Aflibercept for recurrent or recalcitrant polypoidal choroidal vasculopathy in Indian eyes: Early experience

Abstract

Sir, We thank you for your interest in our paper and agree with your concerns.[1 2] All the patients were treated at our institute from the beginning. The definition of recalcitrance/resistance has been mentioned in the text. As this is a retrospective analysis of patients followed over many years, some even before the introduction of antivascular endothelial growth factors in ophthalmology, it is not possible for us to fit all the cases into defined criteria for switching agents, stopping, or continuing treatment. The reason for introducing recurrent cases to aflibercept was to ascertain the possibility of achieving an end point in treatment or at least an increase in the treatment-free interval. Failure to achieve either of the two resulted in a switch back to the original drug as long as the eye had useful vision. We agree that financial issues are important which is why our study had only ten patients, those who could afford the injection and not all cases that were resistant or recalcitrant. This particular study was not intended to test the use of either aflibercept or ziv-aflibercept as primary treatment of polypoidal choroidal vasculopathy; hence, we would not like to extrapolate our results in that direction. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.