Intravitreal Aflibercept for Neovascular Polypoidal Choroidal Vasculopathy (RIVAL Trial)

Inclusion Criteria: * Males and females ≥ 18 years of age. Females of child bearing potential will undergo urine pregnancy testing and be required to use appropriate methods of birth control * ICG and fluorescein angiographic characteristics consistent with active, leaking PCV with subfoveal lesions and/or subfoveal hemorrhage, lipid exudates, PED or fluid * Best corrected early treatment of diabetic retinopathy study (ETDRS) visual acuity at 4 meters between 20/20 - 20/400 (BCVA ETDRS letter score 85 - 20 letters in the study eye) * Lesion Characteristics - leaking lesions consistent with PCV. (No limitations on hemorrhage, fibrosis or atrophy) * Clear ocular media to allow for photography/angiography * Willing and able to comply with clinic visits and study-related procedures * Patients with bilateral disease will only be able to enroll one eye * Provide signed informed consent Exclusion Criteria: * Any history of systemic Anti-VEGF therapy * Current ocular or periocular infection * Active intraocular inflammation * Any comorbid condition that may decrease visual acuity * Any patients who have had intraocular surgery within the past 30 days for any condition * For treatment naïve patients: No prior anti-VEGF, PDT, intravitreal steroids or laser (subfoveal or non foveal) * For previously-treated patients : * Prior anti-VEGF (ranibizumab, bevacizumab, pegaptanib) within 30 days * Prior IAI * Prior PDT , transpupillary thermal therapy (TTT) or radiation within 90 days (a ma…