Abstract
BackgroundThere is no consensus on the optimal initial treatment for polypoidal choroidal vasculopathy (PCV). Our study aimed to report the efficacy of repeated injections of intravitreal ranibizumab with or without photodynamic therapy for the treatment of PCV and to determine the possible factors predictive of visual outcomes.MethodsThe results of the initial treatment of 40 patients with PCV with 3 monthly injections of ranibizumab were retrospectively reviewed. We compared the results in terms of the best corrected visual acuity (BCVA), the central retinal thickness (CRT), the number of injections, the regression rates of polyps and the rates of the reduction of subretinal fluid.ResultsAt the 3-month follow-up, the mean BCVA was significantly increased by 7.3 ± 12.4 letters compared to baseline (p < 0.01). At the 12-month follow-up, the mean BCVA was increased by 3.4 ± 15.4 letters compared to baseline, and there was no significant difference (p > 0.05). The mean CRT at the 12-month follow-up was 593.58 ± 243.64 μm, with an average decrease of 101.55 ± 256.07 μm compared to baseline (p < 0.01). Fifteen eyes (18.8%) showed the complete regression of polyps, and 22 eyes (27.5%) showed a reduction in polyps. The baseline VA, the reduction in subretinal fluids and the greatest lesion diameter were significant independent factors that were predictive of improved VA at the final follow-up.ConclusionsThree monthly injections of ranibizumab as an initial treatment could significantly improve VA in PCV patients in the short term. At 12 months postinjection, ranibizumab treatment could stabilize VA in most PCV patients. The baseline VA, the reduction in subretinal fluids and the greatest lesion diameter were predictive factors for the relative improvement of VA at the final follow-up.
Highlights
There is no consensus on the optimal initial treatment for polypoidal choroidal vasculopathy (PCV)
Studies have shown that samples of aqueous humor and tissue from PCV patients show increased levels of vascular endothelial growth factor (VEGF) [10, 11]
There are studies that report that combined therapy led to improved VA, a reduced subretinal hemorrhage rate and an increased lesion regression rate compared to photodynamic therapy (PDT) alone [12,13,14]
Summary
There is no consensus on the optimal initial treatment for polypoidal choroidal vasculopathy (PCV). Our study aimed to report the efficacy of repeated injections of intravitreal ranibizumab with or without photodynamic therapy for the treatment of PCV and to determine the possible factors predictive of visual outcomes. Studies have shown that samples of aqueous humor and tissue from PCV patients show increased levels of vascular endothelial growth factor (VEGF) [10, 11]. This indicated another treatment modality that could be used for PCV – anti-VEGF agents. The aim of our study is to report the efficacy of repeated injections of intravitreal ranibizumab with or without PDT for the treatment of PCV and to determine the possible factors predictive of visual outcomes
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