Results of 2 years of treatment with as-needed ranibizumab reinjection for polypoidal choroidal vasculopathy

Abstract

PurposeTo investigate the 2-year outcomes of three monthly intravitreal ranibizumab injections followed by as-needed reinjections to treat polypoidal choroidal vasculopathy (PCV).MethodsSeventy-five consecutive eyes with naïve symptomatic PCV with 2 years of follow-up after treatment were studied prospectively.ResultsThe mean (±SD) numbers of injections were 4.2±1.3 that included three monthly injections in the loading phase and 1.6±1.7 during years 1 and 2, respectively (mean 2-year total, 5.6±1.9). The baseline logarithm of the minimum angle of resolution visual acuity (VA) was 0.59±0.51 that improved significantly (p=0.001 for both comparisons) to 0.37±0.33 and 0.41±0.40 at 1 and 2 years, respectively, after the first injection. Although no significant difference was found between years 1 and 2 after the first injection, the VA tended to decrease slightly during year 2. The improved foveal thickness was maintained during year 2. Thirty (40%) eyes and 19 (25%) eyes, respectively, at years 1 and 2 after the first injection had no polypoidal lesions on indocyanine green angiography. A branching vascular network (BVN) remained in all eyes 2 years after the first injection and tended to increase in size during year 2.ConclusionsThe 2-year outcomes showed significant VA and foveal thickness improvements in eyes with PCV. During year 2, the magnitude of the improvement was lower compared with year 1. An as-needed reinjection schedule might not prevent polypoidal lesions or BVNs from regrowing. Further investigations should establish a treatment strategy for PCV.

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

“…We20 also reported that no polypoidal lesions were detected on ICGA images in 30 (40%) of 75 eyes 1 year after the first injection, whereas fewer eyes (19 eyes, 25%) had no polypoidal lesion on ICGA images 2 years after the first injection. Some eyes in which polypoidal lesions were detected on ICGA images 1 month after three monthly injections had no polypoidal lesions on ICGA images 1 year after the first injection.…”

Three-year visual outcome of photodynamic therapy plus intravitreal bevacizumab with or without subtenon triamcinolone acetonide injections for polypoidal choroidal vasculopathy

“…Recently, it has been reported that IVR monotherapy deteriorated mean BCVA during long-term follow-up (0.68±0.43 at baseline; 0.78±0.53 at 36 months) and mean numbers of IVR were 11.45±7.81 during mean follow-up of 42.58±12.59 29. The effectiveness of anti-VEGF may decrease during long-term follow-up, indicating a tachyphylaxis effect or increased resistance to anti-VEGF 29 30…”

Treatment Outcomes in Eyes with Polypoidal Choroidal Vasculopathy with Poor Baseline Visual Acuity

“…[9][10][11] Although anti-VEGF therapy is found to be beneficial in improving or maintaining visual acuity in PCV, [12][13][14][15] the efficacy of anti-VEGF therapy in PCV eyes has not been investigated separately in eyes with poor baseline visual acuity.…”