Prognostic factors of 2-year outcomes of ranibizumab therapy for polypoidal choroidal vasculopathy

Hikichi, Taiichi; Kitamei, Hirokuni; Shioya, Shoko

doi:10.1136/bjophthalmol-2014-305606

Cited by 20 publications

(10 citation statements)

References 36 publications

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“…In previous reports, some baseline characteristics might have been predictive of the treatment outcome,25,53 but it still remains to be elucidated. In the present study, BCVA at baseline was associated with BCVA at 2 years, and was similar to the 2-year outcome of aflibercept or ranibizumab therapy in patients with treatment-naïve AMD 18,54,55. Moreover, IRF at baseline was associated with BCVA at 2 years.…”

Section: Discussionsupporting

confidence: 82%

Two-year outcome of treat-and-extend aflibercept after ranibizumab in age-related macular degeneration and polypoidal choroidal vasculopathy patients

Azuma¹,

Asaoka²,

Matsuda³

et al. 2018

OPTH

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BackgroundThe purpose of the study was to evaluate the 2-year outcome and predictive factors of treat-and-extend aflibercept in patients with eyes affected by typical neovascular age-related macula degenelation (t-AMD) or polypoidal choroidal vasculopathy (PCV), who were switched from ranibizumab.Patients and methodsThe patients underwent three monthly aflibercept injections and subsequent administration following the treat-and-extend protocol. Sixty-two eyes of 62 patients were reviewed retrospectively. R statistical software was used for statistical analysis.ResultsTwenty-two eyes were t-AMD and the remaining 40 eyes were PCV. There was no significant difference in the logarithm of the minimal angle of resolution visual acuity (VA) between baseline and 2 years after switching to aflibercept (0.40 vs 0.40; P=0.99). Multivariate analyses suggested that the following factors were significantly correlated with better VA at 2 years after switching to aflibercept: patients with PCV, the absence of intraretinal fluid at baseline, and better VA at baseline.ConclusionIn conclusion, VA was maintained and there was an anatomical improvement at 2 years in patients with t-AMD and PCV who were switched from ranibizumab to treat-and-extend aflibercept. PCV patients showed more favorable visual outcomes and less injections at 2 years compared to t-AMD patients. Intraretinal fluid and VA at baseline were predictors of VA at 2 years.

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Section: Discussionsupporting

confidence: 82%

Two-year outcome of treat-and-extend aflibercept after ranibizumab in age-related macular degeneration and polypoidal choroidal vasculopathy patients

Azuma¹,

Asaoka²,

Matsuda³

et al. 2018

OPTH

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“…The mean number of injections including the initial three monthly injections administered during the follow-up period was 11.4 (4.5). Fourteen (14 %) patients participated in our previous study [ 18 ] in which prognostic factors of 2-year outcomes of ranibizumab therapy for PCV were investigated.…”

Section: Resultsmentioning

confidence: 99%

Retinal pigment epithelial atrophy over polypoidal choroidal vasculopathy lesions during ranibizumab monotherapy

2016

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BackgroundTo evaluate the quantitative changes of retinal pigment epithelial (RPE) atrophy during 3-year follow-up period of ranibizumab monotherapy for polypoidal choroidal vasculopathy (PCV).MethodsWe retrospectively reviewed consecutive 100 Japanese patients with unilateral symptomatic treatment-naïve PCV who received ranibizumab monotherapy for 3 years. Color fundus photography, spectral-domain optical coherence tomography, and fundus autofluorescence were evaluated for RPE atrophy. Multiple regression analysis was performed to investigate the predictive factors found during univariate analysis to identify an association with increased RPE atrophic areas. RPE atrophic areas overlapping PCV lesions were measured.ResultsThe mean (standard deviation) number of injections was 11.4 (4.50). RPE atrophic area enlarged to 2.91 (5.41 mm2) 3 years after the first injection from 1.22 (1.72 mm2) at baseline, which differed significantly (P = 0.012). Multiple regression analysis showed that larger PCV lesions and larger RPE atrophic areas at baseline were associated with increased RPE atrophic areas. RPE atrophic area overlapping the baseline PCV lesions significantly increased during 3-year follow-up period, whereas RPE atrophic area not overlapping the baseline PCV lesions did not increase significantly.ConclusionRPE atrophy progresses in eyes with PCV during ranibizumab monotherapy and the tendency for development of RPE atrophy within the PCV lesions.

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“…The incidence of choroidal vascular hyperpermeability and punctate hyperfluorescent spots was reported to be between 9.8% and 43.5% [33343536] and between 72.4% and 80% [3537], respectively. In the present study, we first evaluated the incidence of these findings in PCVs with feeder vessels.…”

Section: Discussionmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy with Feeder Vessels: Characteristics, Fellow Eye Findings, and Long-term Treatment Outcomes

Hwang

Kim

Chang

et al. 2017

Korean J Ophthalmol

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PurposeTo evaluate the long-term outcomes of anti-vascular endothelial growth factor (VEGF) therapy for polypoidal choroidal vasculopathy (PCV) with feeder vessels and to investigate fellow-eye findings.MethodsThis retrospective observational study included 14 eyes with treatment-naïve PCV accompanied by feeder vessels that were treated with anti-VEGF monotherapy. The best-corrected visual acuity (BCVA) at baseline was compared with that at the last follow-up. The fellow-eye indocyanine green angiography findings were also analyzed.ResultsThe mean follow-up period was 28.1 ± 19.2 months (range, 12 to 60 months). During the follow-up period, 5.9 ± 2.5 anti-VEGF injections were administered. The logarithm of the minimal angle of resolution (logMAR) BCVAs at the time of diagnosis, at 3 months, and at the last follow-up were 0.81 ± 0.49, 0.55 ± 0.44, and 0.71 ± 0.54, respectively. Although the BCVA at the last follow-up was not different from the baseline value (p=0.809), an improvement of ≥0.2 logMAR BCVA was observed in seven eyes (50.0%). In 11 eyes that underwent bilateral indocyanine green angiography at diagnosis, PCV, branching vascular networks, and late geographic hyperfluorescence were noted in two (18.2%), five (45.4%), and three (27.3%) fellow eyes, respectively. During the follow-up period, the development of polypoidal lesions in the fellow eye was observed in three patients.ConclusionsIn this study, long-term improvement in BCVA was noted in 50% of the included patients who received anti-VEGF monotherapy. A relatively high incidence of pathological findings in the fellow eye and bilateral involvement suggest the need for bilateral examinations.

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Prognostic factors of 2-year outcomes of ranibizumab therapy for polypoidal choroidal vasculopathy

Abstract: Patient age, baseline VA and clusters of grape-like polypoidal lesions predicted VA outcomes 2 years after treatment with IVR for PCV.

Cited by 20 publications

References 36 publications

Two-year outcome of treat-and-extend aflibercept after ranibizumab in age-related macular degeneration and polypoidal choroidal vasculopathy patients

Two-year outcome of treat-and-extend aflibercept after ranibizumab in age-related macular degeneration and polypoidal choroidal vasculopathy patients

Retinal pigment epithelial atrophy over polypoidal choroidal vasculopathy lesions during ranibizumab monotherapy

Polypoidal Choroidal Vasculopathy with Feeder Vessels: Characteristics, Fellow Eye Findings, and Long-term Treatment Outcomes

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