Refractory Neovascular Age-related Macular Degeneration Secondary to Polypoidal Choroidal Vasculopathy

Cho, Minhee; Barbazetto, Irene; Freund, K. Bailey

doi:10.1016/j.ajo.2009.02.012

Cited by 152 publications

(95 citation statements)

References 20 publications

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“…10,12 Bevacizumab (a humanized full-length anti-VEGF Figure 3 Graph showing serial changes in optical OCT mean FCT from baseline to month 12 after treatment. The differences in time course between the two subgroups were not significant.…”

Section: Discussionmentioning

confidence: 99%

“…Photodynamic therapy (PDT) with verteporfin or intravitreal injection of anti-vascular endothelial growth factor (VEGF) has recently been administered for treatment of PCV eyes, and encouraging results have been reported. [5][6][7][8][9][10] Pathogenesis of PCV is not fully understood. However, VEGF may have a role in pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

“…10 Bevacizumab (a humanized full-length anti-VEGF antibody) also appears to have a treatment effect in PCV eyes. 8,9 Kokame et al 13 reported that continuous monthly intravitreal ranibizumab injection was well tolerated in PCV patients; in addition, patients showed stabilized vision and decreased macular edema.…”

Section: Introductionmentioning

confidence: 99%

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Intravitreal bevacizumab and ranibizumab injections for patients with polypoidal choroidal vasculopathy

Cho

Kim

Lee

et al. 2011

Eye

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Purpose To compare the effectiveness of intravitreal injection of bevacizumab and ranibizumab in patients with treatment-naïve polypoidal choroidal vasculopathy (PCV). Methods A total of 66 and 60 eyes of 121 consecutive patients who received intravitreal bevacizumab (1.25 mg) or ranibizumab (0.5 mg) injection for treatment of PCV were retrospectively reviewed. After initial three loading injections by month, injection was performed as needed. Main outcome measures included best corrected visual acuity (BCVA), foveal center thickness (FCT) as assessed by spectral domain optical coherence tomography (SD-OCT), and change in polypoidal lesion on indocyanine green angiography (ICGA). Results At 12 months, average number of injections was 4.72±1.84 in the bevacizumab group and 5.52±1.54 in the ranibizumab group. Mean logarithm of the minimum angle of resolution of BCVA from baseline at 12 months after injection improved by 0.11 in the bevacizumab group (P ¼ 0.02) and by 0.14 in the ranibizumab group (P ¼ 0.01). Average FCT decreased from 368±62.48 to 298±40.77 lm in the bevacizumab group (P ¼ 0.01) and from 371±50.79 to 286±36.93 lm in the ranibizumab group (P ¼ 0.01). Polyp regression rate was 24.2% (16 eyes out of 66 eyes) in the bevacizumab group and 23.3% (14 eyes out of 60 eyes) in the ranibizumab group. There was no statistically significant difference in BCVA improvement achieved, FCT improvement achieved, and polyp regression rate between groups. Conclusion Intravitreal injections of bevacizumab and ranibizumab have similar effects in stabilization of visual acuity, macular edema, and regression of polypoidal complex with PCV eyes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intravitreal bevacizumab and ranibizumab injections for patients with polypoidal choroidal vasculopathy

Cho

Kim

Lee

et al. 2011

Eye

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“…When we performed IA on such AMD cases with large lesions, we sometimes noted knob-like hyperfluorescent lesions at the end of progressing CNV, which resembled the polypoid lesions typically seen in PCV. 21 Cho et al 19 reported that IA revealed these polypoidal lesions in 12 cases of exudative AMD with a poor response to anti-VEGF therapy.…”

Section: Introductionmentioning

confidence: 99%

“…[12][13][14][15][16][17][18] However, some eyes with exudative AMD are refractory to repeated anti-VEGF therapy. 19,20 Clinicians sometimes see cases of typical AMD with a large lesion that shows a poor response to treatment and that shows progression, which results in a poor visual prognosis. When we performed IA on such AMD cases with large lesions, we sometimes noted knob-like hyperfluorescent lesions at the end of progressing CNV, which resembled the polypoid lesions typically seen in PCV.…”

Section: Introductionmentioning

confidence: 99%

Development of polypoidal lesions in age-related macular degeneration

Tsujikawa

Ojima

Yamashiro

et al. 2011

Eye

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Purpose To investigate the development of polypoidal lesions using indocyanine green angiography (IA) in eyes with typical age-related macular degeneration (AMD). Methods We retrospectively reviewed the medical records of 47 consecutive patients (47 eyes) with typical AMD who had been followed up with IA for at least 2 years. Results At the initial visit, although all eyes showed classic and/or occult choroidal neovascularization (CNV) associated with AMD, no eyes showed polypoidal lesions by IA. However, during follow-up, 13 (27.7%) of the 47 eyes did show polypoidal lesions. All polypoidal lesions developed at the edge of persistent CNV or, more often, at the terminus of recently progressed CNV. Of 12 eyes with a final lesion area 48 disc area, 7 (58.3%) showed newly developed polypoidal lesions. In the eyes with these newly developed polypoidal lesions, the mean area of the vascular lesion had extended significantly from 10.50±7.88 mm 2 to 20.87±10.21 mm 2 during follow-up (P ¼ 0.0018). Conclusion The current observation suggests that IA of active AMD sometimes reveals polypoidal lesions if there is progression of the CNV in the subretinal pigment epithelium space.

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Growth of Type 1 Neovascularization Following Cessation of Anti–Vascular Endothelial Growth Factor Therapy as a Possible Explanation for Treatment Resistance

Shah

Freund

2013

JAMA Ophthalmol

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Refractory Neovascular Age-related Macular Degeneration Secondary to Polypoidal Choroidal Vasculopathy

Cited by 152 publications

References 20 publications

Intravitreal bevacizumab and ranibizumab injections for patients with polypoidal choroidal vasculopathy

Intravitreal bevacizumab and ranibizumab injections for patients with polypoidal choroidal vasculopathy

Development of polypoidal lesions in age-related macular degeneration

Growth of Type 1 Neovascularization Following Cessation of Anti–Vascular Endothelial Growth Factor Therapy as a Possible Explanation for Treatment Resistance

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