Predictive factors of resolved retinal fluid after intravitreal ranibizumab for polypoidal choroidal vasculopathy

• Published in: British journal of ophthalmology Vol. 95; no. 11; p. 1555
• Main Authors: Koizumi, Hideki, Yamagishi, Tetsuya, Yamazaki, Taizo, Kinoshita, Shigeru
• Format: Journal Article
• Language: English
• Published: England 01-11-2011
• Subjects: Aged; Aged, 80 and over; Angiogenesis Inhibitors - administration & dosage; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - administration & dosage; Antibodies, Monoclonal, Humanized - therapeutic use; Choroidal Neovascularization - drug therapy; Choroidal Neovascularization - pathology; Choroidal Neovascularization - physiopathology; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Intravitreal Injections; Male; Middle Aged; Prognosis; Ranibizumab; Tomography, Optical Coherence; Treatment Outcome; Visual Acuity - drug effects; Wet Macular Degeneration - drug therapy; Wet Macular Degeneration - pathology; Wet Macular Degeneration - physiopathology
• ISSN: 1468-2079
• DOI: 10.1136/bjophthalmol-2011-300285

To investigate the predictive factors for the resolution of retinal fluid after intravitreal injections of ranibizumab (IVRs) for polypoidal choroidal vasculopathy (PCV).
Forty-seven eyes of 45 patients with symptomatic PCV received 0.5 mg of IVR monthly for 3 months. One month after the third IVR, the presence of dry macula, defined as absence of retinal fluid as detected by the use of optical coherence tomography, was retrospectively evaluated and correlated with clinical characteristics at baseline. Most of the eyes were followed for over 6 months.
Of the 47 eyes, 31 eyes (66%) achieved the dry macula along with increased best-corrected visual acuity (BCVA) (0.64 to 0.46 logarithm of the minimum angle of resolution units, p<0.0001), while the other 16 eyes without dry macula showed no significant change of BCVA. Univariate analyses of the baseline characteristics identified the smaller size of the largest polyp (p=0.0008) and the absence of serous or haemorrhagic pigment epithelial detachment (p=0.045) as predictive factors for the dry macula. Multivariate logistic regression found the independent predictor for the dry macula to be the smaller size of the largest polyp (p=0.001). No severe systemic or ocular adverse events were observed.
IVR may be helpful for resolution of retinal fluid and increased BCVA in the short term, but larger polyps and pigment epithelial detachments at baseline may be negative prognostic factors for a therapeutic response. Further studies are needed to clarify the long-term efficacy of IVR for PCV.