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Keiko Azuma, Hidenori Takahashi, Ryo Obata, Yasuo Yanagi; The efficacy of ranibizumab for polypoidal choroidal vasculopathy in a long-term follow-up. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3837. doi: https://doi.org/.
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The aim of this study was to investigate the long-term efficacy of intravitreal injections of ranibizumab for polypoidal choroidal vasculopathy (PCV), especially focusing on the vascular changes.
A database review was performed for treatment-naïve symptomatic PCV with at least 12 months’ follow-up period. After three monthly injections of ranibizumab, re-treatments were administered when fluid or hemorrhage was present with monthly monitoring. The main outcome measures were the change of the best-corrected visual acuity (BCVA), the diameters of branching vascular networks as measured by indocyanine green angiography (ICGA) and classification of the polypoidal lesion. ICGA was performed at baseline and at least three months after the initial treatment. BCVA was measured by Landolt C-chart and converted to LogMAR units for statistical analysis.
Twenty eyes of twenty patients with PCV were included. Mean baseline BCVA before treatment was -0.27 LogMAR, and mean baseline BCVA at the last follow up was -0.35 LogMAR (P=0.20 with Student’s t-test). Mean greatest linear dimension (GLD) of the branching vascular networks were 3.20 mm at baseline and 3.92 mm at the last follow up (P<0.0001 with Student’s t-test), and enlarged by an average of 30.7% in all 20 eyes. Polypoidal lesions were completely obliterated in 7 eyes (35%), partially obliterated in 6 eyes (30%), and stable or increased in 7 eyes (35%).
Although the visual acuity was maintained by intravitreal injections of ranibizumab, the branching vascular networks enlarged in nearly all cases and polypoidal lesions remained in 65% of the eyes. “As needed” re-treatment protocol might be limited in preventing the growth of branching networks and polypoidal lesions. More effective treatment plans are needed to control PCV.
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