Intravitreal Injection of Ranibizumab for Recovery of Macular Function in Eyes With Subfoveal Polypoidal Choroidal Vasculopathy

Abstract

To evaluate changes in macular function in eyes with polypoidal choroidal vasculopathy (PCV) after intravitreal ranibizumab (IVR) treatment. Twenty-three eyes from 23 patients with treatment-naïve subfoveal PCV received three monthly injections of IVR, followed by as-needed injections. Visual acuity (VA); retinal thickness (measured with optical coherence tomography); macular sensitivity (measured with microperimetry); and focal macular electroretinograms (fmERGs) were evaluated both before the initiation of therapy and after 3 and 12 months. Before treatment, cystoid macular edema was observed in five eyes, serous retinal detachments in 13 eyes, and serosanguinous pigment epithelial detachments in 18 eyes. IVR treatment resulted in substantial morphological improvements and consequent marked reductions in foveal thickness (P = 0.008). Although logarithm of the minimum angle of resolution (logMAR) VA did not improve significantly over the 12-month study period (P = 0.623), the amplitude of the fmERG photopic negative response and macular sensitivity within 4° had increased significantly at 3 months (P = 0.004, P = 0.026, respectively). This trend persisted until the end of the 12-month monitoring period. Among the eyes with preexisting serous retinal detachments, those in which the detachments had resolved completely at 3 months also exhibited greater increases in fmERG a-wave amplitudes (P = 0.048). IVR therapy resulted in morphological improvements and the partial recovery of macular function in eyes with subfoveal PCV. This therapy may improve photoreceptor function by resolving serous retinal detachments.