Short-Term Outcomes of Switching to Ranibizumab in Polypoidal Choroidal Vasculopathy Resistant to Aflibercept Therapy

Background: To evaluate the short-term outcomes of switching to ranibizumab in aflibercept-resistant polypoidal choroidal vasculopathy (PCV). Methods: This retrospective study included 18 eyes diagnosed with aflibercept-resistant PCV. All patients were treated with two to four consecutive ranibizumab injections at 4–5-week intervals. The best-corrected visual acuity (BCVA), and central retinal thickness (CRT) values before and after switching to ranibizumab were compared. The proportion of eyes showing ≥100 µm decrease in retinal thickness and/or complete resolution of fluid after switching was identified. Results: The mean number of aflibercept injections before switching was 5.7 ± 3.3. After switching, a mean of 2.8 ± 0.6 consecutive ranibizumab injections was performed. The mean logarithm of minimal angle of resolution (logMAR) BCVA was 0.41 ± 0.26 (Snellen equivalents = 20/51) before switching, and 0.40 ± 0.30 (20/50) after switching (p = 0.574). The mean CRT was 422.2 ± 152.4 µm before switching, and 400.7 ± 182.0 µm after switching (p = 0.236). A decrease in CRT of ≥100 µm, and/or complete resolution of fluid was noted in three eyes (16.7%). Conclusions: Switching to ranibizumab in aflibercept-resistant polypoidal choroidal vasculopathy was not effective in most patients, suggesting the need for further investigation to seek more effective treatment options for this condition.

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Early Responses to Intravitreal Ranibizumab in Typical Neovascular Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy

Journal of Ophthalmology ◽

10.1155/2011/742020 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 10

Author(s):

Wataru Matsumiya ◽

Shigeru Honda ◽

Hiroaki Bessho ◽

Sentaro Kusuhara ◽

Yasutomo Tsukahara ◽

...

Keyword(s):

Polypoidal Choroidal Vasculopathy ◽

Retinal Thickness ◽

Early Response ◽

Age Related Macular Degeneration ◽

Neovascular Amd ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

Age Related ◽

The Mean ◽

Choroidal Vasculopathy

Purpose. To evaluate the early response to intravitreal ranibizumab (IVR) in two 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 treatments (0.5 mg) were performed every month. Change in the best-corrected visual acuity (BCVA) and central retinal thickness (CRT) was then compared between the tAMD and PCV groups.Results. The mean BCVA logMAR was significantly improved at month 1 and month 3 after the initial IVR in the tAMD group, but there was no change in the PCV group. Both phenotypes showed significant improvements in the CRT during the 3 months after the initial IVR. There were no significant differences in the improvements of the CRT in the tAMD versus the PCV group. In the stepwise analysis, a worse pretreatment BCVA and tAMD lesions were significantly beneficial for a greater improvement of 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.

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Comparison of Outcomes between 3 Monthly Brolucizumab and Aflibercept Injections for Polypoidal Choroidal Vasculopathy

Biomedicines ◽

10.3390/biomedicines9091164 ◽

2021 ◽

Vol 9 (9) ◽

pp. 1164

Author(s):

Yoshiko Fukuda ◽

Yoichi Sakurada ◽

Mio Matsubara ◽

Yuka Hasebe ◽

Atsushi Sugiyama ◽

...

Keyword(s):

Polypoidal Choroidal Vasculopathy ◽

Retinal Thickness ◽

Treated Group ◽

Short Term ◽

Corrected Visual Acuity ◽

Intravitreal Aflibercept ◽

Treatment Naïve ◽

Choroidal Vasculopathy ◽

Selection Of

We compared the short-term outcomes between 3-monthly aflibercept and brolucizumab injections for treatment-naïve polypoidal choroidal vasculopathy (PCV). A total of 52 eyes were included. Patients received 3 monthly intravitreal aflibercept (n = 38) or intravitreal brolucizumab (n = 14). Indocyanine green angiography (ICGA) was performed at baseline and at the 3-month visit. Selection of anti-VEGF agents depended on time. In the brolucizumab-treated group, best-corrected visual acuity (BCVA) improved from 0.27 ± 0.34 (log MAR unit) at baseline to 0.20 ± 0.24 at 3-month visit, which is comparable with the aflibercept-treated group (p = 0.87), after adjustment of confounding factors. Central retinal thickness significantly decreased by 43%−44% in both groups. Subfoveal choroidal thickness also significantly decreased by 20.5% during this interval in the brolucizumab-treated group, which was greater than the aflibercept-treated group. The complete resolution rate of polypoidal lesions on ICGA was significantly higher (p = 0.043) in the brolucizumab-treated group (78.6%) than in the aflibercept-treated group (42.1%). Intraocular inflammation was observed in 14.3% (2/14) in the brolucizumab-treated group only. In short-term follow-up, intravitreal injection of 3-monthly brolucizumab was comparable with aflibercept in terms of BCVA and morphological improvement along with higher resolution of polypoidal lesion(s) on ICGA.

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Real-world outcomes of two-year Conbercept therapy for diabetic macular edema

International Journal of Ophthalmology ◽

10.18240/ijo.2021.03.14 ◽

2021 ◽

Vol 14 (3) ◽

pp. 416-422

Author(s):

Yong Cheng ◽

◽

Ming-Wei Zhao ◽

Tong Qian ◽

◽

...

Keyword(s):

Visual Acuity ◽

Adverse Events ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Vision Loss ◽

Retinal Thickness ◽

Corrected Visual Acuity ◽

The Mean ◽

Number Of Injections ◽

Best Corrected Visual Acuity

AIM: To evaluate the two-year outcomes of patients treated for diabetic macular edema (DME) with intravitreal Conbercept (IVC). METHODS: The clinical data of 30 DME patients (36 eyes) were retrospectively reviewed. The patients were treated with IVC for 3mo. Additional IVC was given at subsequent monthly visits, if needed (3+PRN). The patients were followed up for 24mo. RESULTS: The best-corrected visual acuity (BCVA) at 24mo significantly increased (66.7±15.3 letters) in comparison with the baseline (54.4±15.4 letters, P<0.0001). The mean improvement in BCVA was 11.0±2.9 letters. At 24mo, 44.1% of the eyes surveyed gained ≥15 letters, 52.9% of the eyes gained ≥10 letters, and 70.6% of the eyes gained ≥5 letters. No vision loss was noted in 96.8% of the eyes, and 5.9% of the eyes lost ≥5 letters, but ≤10 letters. The central retinal thickness (CRT) at 24mo was significantly reduced (277.1±122.9 μm) in comparison with the baseline (510.9±186.1 μm, P<0.0001). At 24mo, 43.3% of the patients had a CRT ≤250 μm. The mean number of injections over 24mo was 10.6±2.0. No severe eye or systemic adverse events related to either the drug or injection were noted. CONCLUSION: IVC is safe and effective for the treatment of DME.

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Comparison of the Effectiveness and Prognostic Factors of Intravitreal Ranibizumab between Typical Neovascular Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy over 24 Months of Follow-Up

Ophthalmologica ◽

10.1159/000431000 ◽

2015 ◽

Vol 234 (1) ◽

pp. 33-39 ◽

Cited By ~ 9

Author(s):

Wataru Matsumiya ◽

Shigeru Honda ◽

Keiko Otsuka ◽

Akiko Miki ◽

Takayuki Nagai ◽

...

Keyword(s):

Macular Degeneration ◽

Polypoidal Choroidal Vasculopathy ◽

Age Related Macular Degeneration ◽

Morphological Parameters ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

Age Related ◽

The Mean ◽

Choroidal Vasculopathy

Purpose: To compare the response to ranibizumab between patients with typical neovascular age-related macular degeneration (tAMD) and those with polypoidal choroidal vasculopathy (PCV), and to determine the predictors for the outcomes. Methods: Fifty-nine eyes from 59 consecutive patients (tAMD: 27 eyes, PCV: 32 eyes) were treated with three monthly ranibizumab injections followed by as-needed retreatment. Best-corrected visual acuity (BCVA) and morphological parameters were evaluated over 24 months of follow-up. Results: The mean BCVA in tAMD and PCV patients was significantly improved at 3 months (-0.22 and -0.09 logMAR units, respectively). The improvement in BCVA was sustained up to 24 months in tAMD (p = 0.01) but not in PCV patients. The significant predictor for good response to ranibizumab in tAMD patients was the improvement of BCVA at 3 months, whereas that in PCV patients was the anatomical resolution at 3 months. Conclusions: Ranibizumab is an effective therapy for tAMD and PCV over 24 months. The predictors for good outcome might be different between tAMD and PCV.

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Three-Month Results of Brolucizumab Intravitreal Therapy in Patients with Wet Age-Related Macular Degeneration

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168450 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8450

Author(s):

Katarzyna Michalska-Małecka ◽

Dorota Śpiewak ◽

Dorota Luksa

Keyword(s):

Visual Acuity ◽

Retinal Thickness ◽

Age Related Macular Degeneration ◽

Central Retinal Thickness ◽

Membrane Flow ◽

Membrane Area ◽

Corrected Visual Acuity ◽

Age Related ◽

The Mean ◽

Best Corrected Visual Acuity

The purpose of the study was to evaluate changes in best corrected visual acuity, central retinal thickness, area and flow in the neovascular membrane and to compare therapeutic outcomes from baseline in patients who received three doses of Beovu (brolucizumab) at three-month follow-up. Material and methods: A prospective observational study conducted at the Prof. K. Gibiński University Clinical Center of the Medical University of Silesia in Katowice. Eight patients with exudative form of age-related macular degeneration (AMD) were observed. Results: The mean best corrected visual acuity (BCVA) outcome increased with each subsequent visit. The mean central retinal thickness (CRT) result also improved (decreased) with each subsequent visit, except for the last measurement. A statistically significant change in neovascular membrane area was observed after the first injection. In further treatment, the membrane area underwent changes that were not statistically significant. A statistically significant change in neovascular membrane flow was demonstrated after the first and second injections. Discussion: Our study confirmed the efficacy of brolucizumab in the treatment of patients with exudative AMD in terms of improvements in best corrected visual acuity (BCVA), central retinal thickness (CRT), neovascular membrane area, and neovascular membrane flow area.

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Retinal Sensitivity before and after Silicone Oil Removal Using Microperimetry

Journal of Ophthalmology ◽

10.1155/2019/2723491 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Ghada A. Nassar ◽

Maha M. Youssef ◽

Lameece M. Hassan ◽

Hebatalla S. Makled

Keyword(s):

Silicone Oil ◽

Retinal Sensitivity ◽

Oil Removal ◽

Corrected Visual Acuity ◽

Significant Difference ◽

Before And After ◽

Group A ◽

The Mean ◽

Group B ◽

Best Corrected Visual Acuity

The purpose of the study is to assess the retinal sensitivity, using microperimetry, before and after silicone removal. It included 22 patients admitted for silicone removal after vitrectomy for macula-off retinal detachment. Patients were divided into 2 groups according to the duration of silicone tamponade: Group A: <3 months (included 10 patients), and Group B: 3–6 months (included 12 patients). Retinal sensitivity was tested, using microperimetry, one day before and one month after silicone removal. The best-corrected visual acuity (in LogMAR) significantly improved postoperatively (0.69 versus 1.06 and 0.69 versus 1.07 in Groups A and B, respectively). The mean intraocular pressure (IOP) was 12.89 ± 1.05 mmHg postoperatively versus 14.89 ± 1.76 mmHg preoperatively in Group A (p=0.011) and was 13.33 ± 1.30 mmHg postoperatively versus 15.33 ± 3.11 mmHg preoperatively in Group B (p=0.008). In Group A, the mean postoperative overall retinal sensitivity was 8.70 ± 2.56 dB versus 5.68 ± 2.00 dB preoperatively (p=0.008). In Group B, it was 9.83 ± 3.36 dB versus 7.00 ± 2.55 dB (p=0.002). No statistically significant difference was found between the two groups as regards improvement in overall retinal sensitivity. We concluded that the overall retinal sensitivity significantly increased following silicone removal in both groups. This trial is registered with ISRCTN43187564.

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Neovaskulinės amžinės geltonosios dėmės degeneracijos gydymo ranibizumabu 24 mėnesių morfologiniai ir funkciniai pokyčiai

Medicinos teorija ir praktika ◽

10.15591/mtp.2015.065 ◽

2015 ◽

Vol 21 (3.2) ◽

pp. 413-416

Author(s):

Vilma Jūratė Balčiūnienė ◽

Rosita Lažaunykaitė

Keyword(s):

Visual Acuity ◽

Macular Thickness ◽

Age Related Macular Degeneration ◽

Central Macular Thickness ◽

Corrected Visual Acuity ◽

Age Related ◽

Before And After ◽

The Mean ◽

The Difference ◽

Best Corrected Visual Acuity

Key words: ranibizumab, age-related macular degeneration, central macular thickness. Research objective. To evaluate influence of treatment with vascular endothelial growth factor inhibitor, ranibizumab, for best corrected visual acuity and central macular thickness in patients with neovascular age-related macular degeneration. Materials and methods. In this retrospective study were included treatment – naive patients. Intravitreal injections were performed at Lithuanian University of Health Sciences Kaunas Clinics Eye clinic. In this study were analysed the 24-month morphological and functional outcomes of intravitreal ranibizumab injections. Best corrected visual acuity was meassured using the Snellen chart (Landolt’s rings C optotypes). Optical coherence tomography images were obtained using the spectral – domain OCT (NIDEK RS – 3000 Advance (NIDEK CO LTD, Japan). The central thickness measurements were obtained from macular thickness maps using the digital caliper tool. Results. In this study were included 88 patients. Best corrected visual acuity before treatment was 0.36 ± 0.22. The difference between visual acuity before and after first injection was 0.04 ± 0.22 (p = 0.03). Before fifth injection visual acuity was 0.41 ± 0.21, after – 0.46 ± 0.22 (p = 0.05). Central macular thickness before treatment was 297.81 ± 106.04 μm. The difference between central macular thickness before and after first injection was 85.21 ± 113.37 μm (p < 0.001). Before second injection central macular thickness was 273.57 ± 87.49 μm, after – 234.51 ± 58.96 μm (p = 0.002). Before fourth injection central macular thickness was 237.20 ± 40.87 μm, after – 219.10 ± 42.26 μm (p = 0.04). The mean central macular thickness significantly decreased from 298.15 ± 104.78 to 229.08 ± 56.57 (p < 0.001). In 24 month of treatment the average number of ranibizumab injections was 3.61 ± 1.55. Conclusions. Our study’s results showed that over 24 month best corrected visual acuity improvement was statistically significant after first and fifth injection. Baseline compared with last injection, there was not statistically significant difference. Central macular thickness improvement statistically significant was after first, second and fourth injection. There was statistically significant decreased baseline compared with the last injection. The mean number of ranibizumab injections was 3.61 ± 1.55 in 24 month.

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Vitreomacular interface after anti-VEGF injections in diabetic macular edema

International Journal of Retina and Vitreous ◽

10.1186/s40942-021-00295-8 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Carlos E. Veloso ◽

Daniel N. Brocchi ◽

Rishi P. Singh ◽

Márcio B. Nehemy

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Retinal Thickness ◽

Short Term ◽

Vitreomacular Adhesion ◽

Corrected Visual Acuity ◽

Anti Vegf ◽

Vitreomacular Interface ◽

The Mean

Abstract Background The purpose of this study was to evaluate the incidence of vitreomacular adhesion (VMA) release after anti-VEGF therapy for the treatment of diabetic macular edema (DME) and to evaluate further changes in outcome. Methods This was a retrospective study that enrolled 66 eyes of 66 patients with DME who presented with VMA diagnosed by spectral-domain optical coherence tomography (OCT) at baseline. VMA was classified as focal (attachment: ≤ 1500 μm) or broad (attachment: > 1500 μm). All patients received at least three monthly intravitreal injections of an anti-VEGF agent. Follow-up visits were performed 1 month after each injection to evaluate the incidence of VMA release. Results The mean patient age was 61.4 years (range: 29 to 78 years), and 72.7 % were male. The mean best-corrected visual acuity was 0.62 logMAR, and the mean central retinal thickness (CRT) was 473 μm at baseline. The mean length of follow-up was 18.5 months, and the mean number of injections was 5.8. The intravitreal drugs used were aflibercept (40.9 %), ranibizumab (37.9 %) and bevacizumab (21.2 %). Forty-seven eyes had broad VMA, and 19 had focal VMA. Twenty-two eyes (33.3 %) developed VMA release following a mean of 5.7 injections (range: 3–13). Sixteen eyes (72.7 %) with focal VMA and 6 eyes (27.3 %) with broad VMA at baseline developed VMA release. Twenty-one eyes that developed VMA release showed an improvement in CRT following VMA release (mean: -106 μm; range: 22 to 289 μm). Conclusions VMA release occurs in approximately 1/3 of patients with DME following anti-VEGF therapy. Most of them show a short-term decrease in CRT.

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Intravitreal Ranibizumab for the Treatment of Choroidal Neovascularizations Associated with Pathologic Myopia: A Prospective Study

Ophthalmologica ◽

10.1159/000369397 ◽

2014 ◽

Vol 233 (1) ◽

pp. 2-7 ◽

Cited By ~ 2

Author(s):

Nataliya V. Pasyechnikova ◽

Volodymyr O. Naumenko ◽

Andrii R. Korol ◽

Oleg S. Zadorozhnyy ◽

Taras B. Kustryn ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Thickness ◽

Central Retinal Thickness ◽

Pathologic Myopia ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

The Mean ◽

A Prospective Study ◽

Best Corrected Visual Acuity

Purpose: It was the aim of this study to determine the efficacy of intravitreal ranibizumab as treatment of choroidal neovascularizations associated with pathologic myopia. Materials and Methods: In an uncontrolled, prospective time series cohort study, 65 eyes of 64 consecutive patients with choroidal neovascularization associated with pathologic myopia were treated with intravitreal ranibizumab and observed over 12 months. The change in best-corrected visual acuity (BCVA) at 6 and 12 months served as primary end point. Safety, central retinal thickness, neovascularization activity on fluorescein angiography and the number of ranibizumab injections were secondary end points. Results: BCVA improved significantly throughout the follow-up (p = 0.001). The mean BCVA was 0.2 at baseline (SD 0.13) and 0.4 at 12 months (SD 0.21). Improvement was strongest within the first 3 months (p = 0.0001). The mean central retinal thickness showed a reduction from 313 μm (SD 82) to 243.5 μm (SD 31; p = 0.0001). Conclusion: Intravitreal ranibizumab offers a safe and effective treatment for choroidal neovascularizations in pathologic myopia.

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Intravitreal conbercept for choroidal neovascularisation secondary to pathological myopia in a real‐world setting in China

BMC Ophthalmology ◽

10.1186/s12886-021-01877-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xin Nie ◽

Yulong Wang ◽

Hong Yi ◽

Yanbin Qiao

Keyword(s):

Visual Acuity ◽

Adverse Events ◽

Real World ◽

Retinal Thickness ◽

Central Retinal Thickness ◽

Pathological Myopia ◽

Corrected Visual Acuity ◽

Real World Setting ◽

The Mean ◽

Best Corrected Visual Acuity

Abstract Background To evaluate the 12-month efficacy and safety of intravitreal conbercept for myopic choroidal neovascularization (CNV). Methods A retrospective, observational study. Thirty-four eyes of 34 pathologic myopic patients with CNV were treated with intravitreal conbercept (IVC) 0.5 mg with a follow up of 12 months. After the first injection, administration of conbercept followed a pro re nata (PRN) regimen. Outcomes included best corrected visual acuity (BCVA), central retinal thickness (CRT), CNV size, the total number of treatments, and adverse events. Results The mean patient age was 55.88 ± 16.17 years, and the mean eye spherical equivalent was − 8.72 ± 3.75 D. The mean number of IVC over 12 months was 2.12 ± 0.69. Overall, best-corrected visual acuity(BCVA)improved from 0.86 ± 0.33 logMAR at baseline to 0.44 ± 0.32 logMAR at month 12 (p < 0.001), mean improvement of vision was 4.12 ± 2.69 lines. Mean central retinal thickness reduced from 285.9 ± 104.6 µm at baseline to 192.1 ± 97.5 µm at month 12 (p < 0.001). Mean CNV size decreased from 0.52 ± 0.38 mm2 at baseline to 0.31 ± 0.19 mm2 at 12 months (p < 0.05). All the 34 eyes had reduced or stable size of CNV. Thirty-two eyes (94.12 %) showed the absence of CNV leakage at the end of the study period. No severe systemic or ocular adverse events were observed. Conclusions Intravitreal conbercept 0.5 mg was safe and effective for treatment of myopic CNV over 12 months in a real-world setting.

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