Purchase this article with an account.
Takeya Kohno, Manabu Yamamoto, Tomoko Tamachi, Jyunji Asai, Natsuko Oishi, Shinsuke Ataka, Ayako Yasui, Akira Cho, Michiko Hirabayashi, Kunihiko Shiraki; 5-year outcome of initial treatment with ranibizumab monotherapy for polypoidal choroidal vasculopathy with good visual acuity. Invest. Ophthalmol. Vis. Sci. 2017;58(8):880.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the 5-year outcome of intravitreal injections of ranibizumab (IVR) as initial treatment for polypoidal choroidal vasculopathy (PCV) with good visual acuity.
We retrospectively reviewed twenty-three previously untreated patients with PCV with an initial decimal visual acuity (VA) of ≥0.7. Patients initially received 3 monthly IVR, followed by a pro re nata regimen for the first 3 years and continued anti-VEGF treatment of ranibizumab or aflibercept for subsequent 2 years. Supplemental half-fluence photodynamic therapy (PDT) or switching to the aflibercept were done in cases of poor or no response to IVR monotherapy
Mean logarithm of the minimum angle of VA was 0.03 at baseline, 0.00 at month 12 (P = 0.086), 0.00 at month 24 (P = 0.026), 0.08 at month 36 (P = 0.71) and 0.09 at month 60 (P =0.23). Significant visual loss occurred in 3 eyes after 2 years. After loading treatments, retreatments were required in 21 of 23 eyes (91.3 %) during 5 years. Supplementary PDT and switching to aflibercept were required in 7 eyes (30.4 %) and in other 2 eyes (8.7%), respectively. In years 4-5, among 6 eyes without recurrence during the first 2 years, 4 eyes had recurrence. Of the remaining 17 eyes with recurrence, 15 eyes re-recurred and required additional anti-VEGF treatments. Dry macula obtained in 13 eyes (56.5 %) at month 60. Geographic atrophy was developed in 8 eyes (34.8 %) of which it appeared in 6 eyes after 3 years.
Most PCV patients with good VA maintained or improved VA for 5 years, but required repeated treatments. Ranibizumab monotherapy alone was insufficient to obtain stable conditions in approximately 40% of patients.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
This PDF is available to Subscribers Only