Long-term Visual Outcome and Prognostic Factors After Intravitreal Ranibizumab Injections for Polypoidal Choroidal Vasculopathy

AIM: To evaluate the long-term effect and safety of focal laser photocoagulation treatment in eyes with polypoidal choroidal vasculopathy (PCV). METHODS: Medical records of 13 eyes of 13 patients with PCV were followed-up for more than 2y after focal laser photocoagulation treatment. The patients were diagnosed with PCV using indocyanine green angiography, and eyes with other comorbid ocular diseases were excluded. The measurement outcomes of the study were the post-treatment regression and recurrence of polyps, complications, and changes in visual acuities. Paired t-test was performed to compare visual outcome before and after the treatment. RESULTS: The mean age of the 13 patients was 70.2±5.5y, and the follow-up period was 72.3±31.0 (range, 25-118)mo. Three eyes had juxtafoveal polyps and 10 eyes had extrafoveal polyps. Of the 13 eyes, 9 eyes (69.2%) had regression of polyps 1.7±1.2 (range, 0.9-4)mo after focal laser photocoagulation. Five eyes (55.6%) showed recurrence of polyps during the follow-up periods, and the recurrence period was 12.8±18.9 (range, 1.9-48)mo. Mild subretinal hemorrhage occurred in two eyes (15.4%) 27 and 72d after laser treatment, respectively. There were no statistically significant differences in visual acuities at baseline; 1, 2, 3y post-treatment (all P>0.05); and last follow-up (0.63±0.5, 0.73±0.70, 0.67±0.57, 0.75±0.7, and 0.95±0.8 logMAR, respectively). CONCLUSION: Focal laser photocoagulation is beneficial for early regression of polyps in eyes with PCV and does not result in significant submacular hemorrhage during the long-term follow-up. Furthermore, it can be primarily considered in eyes with PCV with extrafoveal or juxtafoveal polyps to regress risky polyps as well as to maintain visual acuity without serious hemorrhagic complications.

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Verteporfin Photodynamic Therapy Combined with Intravitreal Ranibizumab for Polypoidal Choroidal Vasculopathy Controversy Concerning Long-Term Followup

Case Reports in Medicine ◽

10.1155/2012/897097 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

Maribel Fernández ◽

María Gil ◽

Francisco Gomez-Ulla ◽

Pablo Charlón

Keyword(s):

Photodynamic Therapy ◽

Polypoidal Choroidal Vasculopathy ◽

Hot Spot ◽

Spot Size ◽

Long Term Results ◽

Controlled Clinical Trials ◽

Intravitreal Ranibizumab ◽

Long Period ◽

Choroidal Vasculopathy

Purpose. To show the long-term results of intravitreal ranibizumab combined with photodynamic therapy (PDT) for the treatment of polypoidal choroidal vasculopathy (PCV).Methods. We analyzed the progress of two patients for 36 and 58 months, respectively. We only used PDT for the treatment in the area of the active PCV or “hot spot” evident on the indocyanine green angiography (ICGA). The spot size was chosen so as to cover only the active neovascular lesion. We combined intravitreal ranibizumab with PDT when PCV remained active without visible polyps in ICGA or without a response to PDT.Conclusion. Administration, as required, of verteporfin photodynamic therapy combined with intravitreal ranibizumab is an effective treatment for symptomatic polypoidal choroidal vasculopathy. These data need to be confirmed in large, prospective, and controlled clinical trials which are randomized and carried out over a long period.

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Long-term results of photodynamic therapy or ranibizumab for polypoidal choroidal vasculopathy in LAPTOP study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312419 ◽

2018 ◽

Vol 103 (6) ◽

pp. 844-848 ◽

Cited By ~ 10

Author(s):

Noriko Miyamoto ◽

Michiko Mandai ◽

Akio Oishi ◽

Shunichiro Nakai ◽

Shigeru Honda ◽

...

Keyword(s):

Photodynamic Therapy ◽

Polypoidal Choroidal Vasculopathy ◽

Long Term Results ◽

Intravitreal Ranibizumab ◽

Macular Atrophy ◽

Long Term Effect ◽

First Choice ◽

Choroidal Vasculopathy

Background/aimWe previously reported that ranibizumab performed better on visual prognosis than photodynamic therapy (PDT) in a Ranibizumab (Lucentis) And Photodynamic Therapy On Polypoidal choroidal vasculopathy (LAPTOP) study. To determine if the first-choice treatment, either PDT or intravitreal ranibizumab, has a long-term effect in patients with polypoidal choroidal vasculopathy (PCV).MethodsWe reviewed medical records of patientsrandomised to either PDT (29 eyes) or ranibizumab (27 eyes) from July 2009 to June 2011 in LAPTOP study. Retreatment or switching to other treatments were at the investigator’s discretion after release from the 2-year LAPTOP study up to 5years. We evaluated visual acuity (VA), continuity of initial treatment, percentage of dry macula achievement and macular atrophy at 5 years.ResultsThe logarithm of minimal angle of resolution VA was 0.56 in the PDT and 0.44 in the ranibizumab groups at baseline (p=0.101) and was 0.55 and 0.28 at 5years, respectively (p<0.05). More than 70% of the patients converted to aflibercept in following years. Achievement percentages of dry macula were 74% (PDT) and 63% (ranibizumab) at 5years, and macular atrophy was detected in 78% (PDT) and 60% (ranibizumab) with a mean area of 7.7 and 3.5 mm2, respectively (p=0.155).ConclusionsThe better VA in the initial ranibizumab group compared with the PDT group at 2 years was retained at the 5-year follow-up.

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Comparison of Two-Year Outcome of Photodynamic Therapy in Combination with Intravitreal Aflibercept or Ranibizumab for Polypoidal Choroidal Vasculopathy

Applied Sciences ◽

10.3390/app11031194 ◽

2021 ◽

Vol 11 (3) ◽

pp. 1194

Author(s):

Hsin-Yu Weng ◽

Tzu-Lun Huang ◽

Pei-Yao Chang ◽

Wei-Ting Ho ◽

Yung-Ray Hsu ◽

...

Keyword(s):

Photodynamic Therapy ◽

Combination Therapy ◽

Polypoidal Choroidal Vasculopathy ◽

Visual Outcome ◽

Intravitreal Ranibizumab ◽

Regression Rate ◽

Younger Age ◽

Intravitreal Aflibercept ◽

Choroidal Vasculopathy

Purpose: To compare the two-year visual and anatomical outcomes of combination therapy of photodynamic therapy (PDT) with intravitreal aflibercept (IVA) or intravitreal ranibizumab (IVR) for patients with polypoidal choroidal vasculopathy (PCV), and to investigate the clinical factors with final visual outcome and retreatment. Methods: A retrospective medical chart review was performed for 55 eyes from 55 patients with PCV treated by a combination therapy of prompt PDT with either IVA (n = 30) or IVR (n = 25). Baseline data and treatment outcomes during the 24-month follow-up were compared between the two groups. Primary outcomes were the changes in best-corrected visual acuity (BCVA) and the rate of complete polyp regression. Secondary outcomes were the changes in central retinal thickness (CRT) and the rate of dry macula. Retreatment was administered in cases with persistent or recurrent submacular or intramacular fluid. Results: The BCVA significantly improved in the IVA/PDT group at every 6-month visit compared to the baseline. In the IVR/PDT group, there was a significant improvement of BCVA only at 6-months and 12-months, but not at 18-months and 24-months compared to the baseline. There were no significant differences in the BCVA change or CRT change between the two groups at every 6-month visit. A complete polyp regression rate at 3-months was 53.3% in IVA/PDT, and 52.0% in IVR/PDT. Significantly higher dry macula rate in Month 6 and 18 in the IVA/PDT group than in IVR/PDT group. Retreatment was performed in 26.7% patients in IVA/PDT, and in 60.0% patients in the IVR/PDT group. There were significantly lower retreatment rates in the IVA/PDT group than those in the IVR/PDT group. Better final BCVA was associated with better baseline BCVA and a younger age. Retreatment was associated with complete polyp regression at 3-months. Conclusions: Significant visual improvement was demonstrated in the IVA/PDT group at every 6-month visit, but only at a 6-month and a 12-month follow-up in the IVR/PDT group. Although changes of the BCVA/CRT and complete polyp regression rate were comparable between two groups, the IVA/PDT group required less retreatment and attained more dry macula results. Better baseline BCVA and younger age were associated with a better visual outcome.

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