Two-year follow-up of ranibizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy

Abstract

Rei Nemoto,1,2 Masahiro Miura,1,2 Takuya Iwasaki,1,2 Hiroshi Goto21Department of Ophthalmology, Tokyo Medical University, Ibaraki Medical Center, Ami, Ibaraki, Japan; 2Department of Ophthalmology, Tokyo Medical University, Nishi-Shinjuku, Tokyo, JapanPurpose: We evaluated the 2-year efficacy of combined intravitreal ranibizumab (IVR) treatment and photodynamic therapy (PDT) for treatment-naïve polypoidal choroidal vasculopathy (PCV).Patients and methods: Twenty-two eyes of 22 Japanese patients with treatment-naïve PCV were prospectively recruited. All eyes had angiographic features of PCV according to indocyanine green angiography. The initial combination treatment regimen included a session of PDT with IVR. A total of three consecutive IVR treatments were given at 4-week intervals. Eyes were retreated with IVR or PDT at specific times. We evaluated the mean visual acuity and mean central retinal thickness (CRT) at 3, 6, 9, 12, 18, and 24 months after initial treatment.Results: At month 9, visual acuity had improved by 5.7 letters (P = 0.10). Subsequently, mean visual acuity gradually decreased, and the difference from baseline was diminished to 2.9 letters at 24 months (P = 0.43). Mean CRT was significantly decreased from baseline over the 24-month follow-up (P < 0.05).Conclusion: With PDT combined with IVR for PCV, visual acuity improved during year 1, but the benefit decreased in year 2.Keywords: photodynamic therapy, polypoidal choroidal vasculopathy, ranibizumab