{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T16:54:33Z","timestamp":1765817673453,"version":"3.48.0"},"reference-count":17,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,6,16]]},"published-print":{"date-parts":[[2017,8]]},"abstract":"\n Purpose<\/jats:title>\n The purpose of this study is to compare the efficacy and safety of intravitreal aflibercept (IVA) with sham photodynamic therapy (sPDT) versus IVA with verteporfin PDT (vPDT) in a Caucasian population with treatment-naive polypoidal choroidal vasculopathy (PCV), enrolling into a treat and extend (T&E) regimen.<\/jats:p>\n <\/jats:sec>\n \n Methods and analysis<\/jats:title>\n Randomised, double-masked, sham-controlled, multicentre phase 4 investigator-driven clinical trial. The primary outcomes are (1) change in best-corrected visual acuity (BCVA) from baseline and (2) polyp regression at week 52, assessed by indocyanine green angiography (ICGA). Fifty patients with treatment-naive PCV will be recruited from Portuguese and Spanish clinical sites. Eligible patients will receive monthly IVA for 3 months (week 0, week 4 and week 8). At week 16, all patients will repeat ICGA and undergo central randomisation (1:1 ratio) into one of the following groups: Group 1\u2014IVA T&E + vPDT; Group 2\u2014IVA T&E + sPDT. PDT will be performed at week 16, week 28 and week 40 in the presence of active polyps. After week 16, the presence of macular fluid on optical coherence tomography will determine the schedule of observations. When present, the interval between visits\/injections will decrease 2\u2009weeks (minimum 6\u2009weeks). When not, the interval between visits\/injections will increase 2\u2009weeks (maximum 12\u2009weeks). Efficacy will be evaluated based on BCVA, central retinal thickness and polyp regression. Safety parameters will include assessment of intraocular pressure, adverse events and serious adverse events.<\/jats:p>\n <\/jats:sec>\n \n Ethics and dissemination<\/jats:title>\n This study was designed and shall be implemented and reported in accordance with the International Conference on Harmonisation (ICH) Harmonised Tripartite Guidelines for Good Clinical Practice, with applicable local regulations and with the ethical principles laid down in the Declaration of Helsinki. The study received approval from Comiss\u00e3o de \u00c9tica para a Investiga\u00e7\u00e3o Cl\u00ednica and Comit\u00e9 \u00c9tico de investigaci\u00f3n Cl\u00ednica del Hospital Universitari de Bellvitge.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n This study is registered under the EudraCT number: 2015-001368-20 and the ClinicalTrials.gov Identifier:\n NCT02495181<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-015785","type":"journal-article","created":{"date-parts":[[2017,8,29]],"date-time":"2017-08-29T20:10:15Z","timestamp":1504037415000},"page":"e015785","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Protocol for a randomised, double-masked, sham-controlled phase 4 study on the efficacy, safety and tolerability of intravitreal aflibercept monotherapy compared with aflibercept with adjunctive photodynamic therapy in polypoidal choroidal vasculopathy: the ATLANTIC study"],"prefix":"10.1136","volume":"7","clinical-trial-number":[{"clinical-trial-number":"nct02495181","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02495181","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1014-0483","authenticated-orcid":false,"given":"Jo\u00e3o Pedro","family":"Marques","sequence":"first","affiliation":[{"name":"Association for Investigation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal"},{"name":"Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal"},{"name":"Department of Ophthalmology, Centro Hospitalar e Universit\u00e1rio de Coimbra (CHUC), Coimbra, Portugal"}]},{"given":"Cl\u00e1udia","family":"Farinha","sequence":"additional","affiliation":[{"name":"Association for Investigation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal"},{"name":"Department of Ophthalmology, Centro Hospitalar e Universit\u00e1rio de Coimbra (CHUC), Coimbra, Portugal"}]},{"given":"Miguel \u00c2ngelo","family":"Costa","sequence":"additional","affiliation":[{"name":"Association for Investigation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal"}]},{"given":"\u00c2ngela","family":"Ferr\u00e3o","sequence":"additional","affiliation":[{"name":"Association for Investigation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal"}]},{"given":"Sandrina","family":"Nunes","sequence":"additional","affiliation":[{"name":"Association for Investigation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal"}]},{"given":"Rufino","family":"Silva","sequence":"additional","affiliation":[{"name":"Association for Investigation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal"},{"name":"Department of Ophthalmology, Centro Hospitalar e Universit\u00e1rio de Coimbra (CHUC), Coimbra, Portugal"},{"name":"Faculty of Medicine, University of 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