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

Abstract

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.

Six-year outcomes of antivascular endothelial growth factor monotherapy for polypoidal choroidal vasculopathy

“…My previous study23 of ranibizumab therapy for PCV found progressing RPE atrophy and a tendency for development of RPE atrophy within the PCV lesions. In the current study, the BCVA at the end of the 6 years was significantly worse in eyes with macular atrophy compared with those without macular atrophy.…”

How do polypoidal choroidal vasculopathy patients fare long term - A real world data

“…Eyes with RPE atrophy and scarring showed a poor visual outcome. 14 The present study was conducted in real-life practice and variability in treatment protocols with line ant adherence to treatment protocols might have affected our final outcomes.…”

Polypoidal choroidal vasculopathy: An update on current management and review of literature

“…Moreover, progressing RPE atrophy and significant macular atrophy contributed to the poor visual gain in these patients. [175]…”

“…Pigment epithelial tears, post-injection SRH and vitreous hemorrhage, and RPE atrophy are few complications reported. [175178179] A favorable response to anti-VEGF therapy was found in young patients, with better baseline VA, smaller lesion size, smaller size of the largest polyp, single polyp, absence of cluster of grapes on ICGA. [180181182183] The subfoveal CT decreases with ranibizumab and may be associated with PCV activity.…”