The Early Responses To Intravitreal Ranibizumab In Typical Neovascular Age-related Macular Degeneration And Polypoidal Choroidal Vasculopathy

Abstract

Purpose: : To evaluate the early response to intravitreal ranibizumab (IVR) in different phenotypes of age-related macular degenerations (AMD): typical neovascular AMD (tAMD) and polypoidal choroidal vasculopathy (PCV).

Methods: : Sixty eyes from 60 patients (tAMD 28, PCV 32 eyes) were recruited. Three consecutive IVR (0.5mg) were performed every month. Gender, age, best-corrected visual acuity (BCVA), greatest linear dimension (GLD), central retinal thickness (CRT), history of smoking, the presence of hypertension and diabetes mellitus and body mass index were compared between tAMD and PCV groups. Stepwise multiple regression analyses using lesion phenotype (tAMD or PCV) as an explanatory variable was performed for predicting the BCVA at 3 months after the initial IVR.

Results: : No differences were detected in baseline parameters between the tAMD and PCV groups except of significantly larger mean GLD in the PCV group (tAMD: 3530µm, PCV: 4558µm, P=0.0068). The mean BCVA logMAR was significantly improved at month1 (-0.093, P=0.0084) and month3 (-0.12, P=0.00080) after the initial IVR in the tAMD group, while there was no change at month1 (-0.086, P=0.38) and month 3(-0.011, P=0.55) in the PCV group. The mean CRT was significantly decreased from the baseline at month1 (tAMD: -104µm,P<0.0001 ; PCV: -118µm, P<0.0001) and month3 (tAMD: -129µm,P<0.0001 ; PCV: -173µm, P<0.0001) with the treatments in both groups. In the stepwise analysis, a better pre-treatment BCVA and lesions with tAMD were significantly beneficial for the better BCVA at 3 months after the initial IVR.

Conclusions: : The phenotype of tAMD showed a significantly better early response to IVR than PCV in terms of BCVA improvement.

Keywords: age-related macular degeneration • choroid: neovascularization • vascular endothelial growth factor