Abstract
Purpose:
To investigate the third-year results of ranibizumab monotherapy for polypoidal choroidal vasculopathy (PCV) in individualized treatment regimens based on the clinical course during a 2-year follow-up period.
Methods:
One hundred seven consecutive eyes of 100 treatment-naïve Japanese patients with symptomatic PCV received monthly intravitreal injections of ranibizumab for 3 months followed by as-needed reinjections based on monthly examinations and a 2-year follow-up. At the beginning of the third year, 70 eyes of 70 patients were treated individually based on their clinical courses during the 2-year follow-up period and followed for 1 year. Each patient was treated with one of the following four regimens: as-needed injections based on quarterly examinations, as-needed injections based on monthly examinations, monthly ranibizumab injections, or a treat-and-extend protocol.
Results:
The logarithm of the minimum angle of resolution VAs significantly improved at 1 (0.44 ± 0.44, P=0.002) and 2 years (0.51 ± 0.42, P=0.048) after the first injection compared to baseline VA (0.63 ± 0.52); however, the significant improvement was not maintained 3 years after the first injection (0.53 ± 0.47, P=0.241). No difference was found in the VA levels between months 24 and 36 in each treatment group, except in the group that received as-needed injections based on quarterly examinations in which the VA at month 36 decreased significantly (P=0.001) compared to month 24. In all four groups, 1, 2, and 3 years after the first injection the fovea was significantly thinner compared with baseline. No difference was found in the foveal thickness between months 24 and 36 in each treatment group, except in the as-needed injection group based on quarterly examinations; the fovea at month 36 was significantly (P=0.004) thicker than at month 24.
Conclusions:
The individualized treatment regimen in the third year generally maintained the VA at baseline and the end of 2 years despite unfavorable results in the quarterly examination protocol.
Keywords: 412 age-related macular degeneration