Abstract
Purpose:
To determine the correlation between changes in the subfoveal choroidal thickness (CT) and outcomes 1 year after ranibizumab therapy for polypoidal choroidal vasculopathy (PCV).
Methods:
Eighty-six consecutive eyes of 80 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. The following measurements were performed at baseline, 1 month after three monthly injections, and 1 year after the first injection: CT by enhanced-depth optical coherence tomography (OCT), foveal thickness (FT) by spectrum-domain OCT, simultaneous fluorescein angiography (FA), and indocyanine green angiography.
Results:
The mean (± standard deviation) number of injections during 1 year was 4.3 ± 1.2. The mean visual acuity (VA) improved significantly from 0.42 to 0.33 logarithm of the minimum angle of resolution (logMAR) (P=0.001, paired t-test). The mean CT and FT improved significantly from 271 μm and 347 μm, respectively, to 212 μm and 203 μm (P=0.001 for both comparisons, paired t-test). Simple regression analysis showed that the change ratio of the CT, i.e., baseline CT-CT 1 year after the first injection/baseline CT, was correlated significantly with the change ratio of the FT, i.e., baseline FT-FT 1 year after the first injection/baseline FT at baseline (P=0.04, r=0.22) but was not correlated with the change ratio of the VA, i.e., baseline logMAR VA-logMAR VA 1 year after the first injection/baseline logMAR VA, or the number of injections during the 1-year follow-up period. The change ratio of the CT was significantly higher in eyes with choroidal hyperpermeability (0.21 ± 0.17, n=20) than in eyes without choroidal hyperpermeability (0.12 ± 0.12, n=66) (P=0.007, unpaired t-test) and in eyes in which the polypoidal lesions improved 1 year after the first injection (0.38 ± 0.28, n=44) than in eyes in which the polypoidal lesions remained stable or worsened (0.24 ± 0.35, n=42) (P=0.048, unpaired t-test).
Conclusions:
Changes in choroidal thickness may be associated with outcomes of ranibizumab therapy for PCV.
Keywords: 412 age-related macular degeneration •
462 clinical (human) or epidemiologic studies: outcomes/complications