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Taiichi Hikichi, Makoto Higuchi, Takuro Matsushita, Shoko Kosaka, Reiko Matsushita, Kimitaka Takami, Hideo Ohtsuka, Hiroko Ariga; Factors Predictive Of Outcomes 1 Year After Ranibizumab Therapy In Japanese Patients With Polypoidal Choroidal Vasculopathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2058.
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To determine the factors predictive of outcomes 1 year after ranibizumab therapy for polypoidal choroidal vasculopathy (PCV).
One hundred fifty-five consecutive eyes of 144 Japanese patients with symptomatic PCV received one intravitreal injection of 0.5 mg ranibizumab monthly for 3 months followed by an as-needed reinjection schedule. A stepwise logistic regression model was used to estimate the independent factors predictive of better visual acuity (VA), improvement of VA, and the need for fewer injections 1 year after the first injection.
The mean (± standard deviation) number of injections during 1 year was 4.2 ± 1.3. The mean VA improved significantly from 0.63 to 0.43 logarithm of the minimum angle of resolution (P=0.001, Wilcoxon matched-pairs signed-ranks test). The VA improved and decreased more than 0.3 logMAR unit 1 year after the first injection in 54 (35%) and 14 (9%) eyes, respectively. Stepwise logistic regression analysis showed that absence of both a history of photodynamic therapy (PDT) and clusters of grape-like polypoidal lesion at baseline and improvement of polypoidal lesions 3 months after the first injection were significant and independent factors predictive of better VA 1 year after treatment; and the absence of both a history of PDT and clusters of grape-like polypoidal lesion at baseline, the presence of polypoidal PCV at baseline, worse baseline VA, and improvement of polypoidal lesions 3 months after the first injection were significant and independent factors predictive of VA improvement. No factors were predictive of fewer ranibizumab injections during 1 year after the first injection.
The baseline clinical characteristics and response of polypoidal lesions to ranibizumab injections predicted favorable VA outcomes after ranibizumab therapy. These findings might help establish treatment strategies for PCV.
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