Abstract
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.
Highlights
Polypoidal choroidal vasculopathy (PCV) is a distinct type of choroidal neovascularization (CNV) that is characterized by polypoidal lesions and branching vascular networks [1]
In polypoidal choroidal vasculopathy (PCV), eyes treated with aflibercept usually show a greater reduction in macular thickness, and higher polyp regression rate than those treated with ranibizumab [6,7]
The current study addresses the question of whether switching to ranibizumab could be a useful alternative in aflibercept-resistant PCV
Summary
Polypoidal choroidal vasculopathy (PCV) is a distinct type of choroidal neovascularization (CNV) that is characterized by polypoidal lesions and branching vascular networks [1].Previously, photodynamic therapy (PDT) was used as the primary treatment option for this condition. Anti-vascular endothelial growth factor (VEGF) therapy has widely replaced PDT as an effective first-line treatment for PCV [2,3]. Ranibizumab and aflibercept are widely used as effective anti-VEGF drugs to treat. In PCV, eyes treated with aflibercept usually show a greater reduction in macular thickness, and higher polyp regression rate than those treated with ranibizumab [6,7]. 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. 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
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