Continuous anti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy: 6-month results

Br J Ophthalmol. 2010 Mar;94(3):297-301. doi: 10.1136/bjo.2008.150029. Epub 2009 Sep 1.

Abstract

Aim: To evaluate the short-term efficacy and safety of monthly intravitreal injections of ranibizumab in patients with polypoidal choroidal vasculopathy (PCV) and active exudation or haemorrhage.

Methods: A prospective, open-label trial of monthly intravitreal ranibizumab (0.5 mg) injections for PCV in 12 eyes of 12 patients was performed. The primary outcome measures were stabilisation of vision (loss <15 ETDRS letters). Secondary outcome measures included incidence of ocular and systemic adverse events, and changes in subretinal haemorrhage, central foveal thickness (CFT) and polypoidal complexes on indocyanine green angiography at 6 months.

Results: Baseline findings included eight eyes with subretinal fluid, six eyes with subretinal haemorrhage and five eyes with macular oedema (CFT >275 microm). No patient lost > or = 15 letters in visual acuity at 6 months. Subretinal fluid decreased in 5/8 eyes (63%). Subretinal haemorrhage resolved in 6/6 eyes (100%). Macular oedema improved in 4/5 eyes (80%). Polypoidal complexes decreased in 4/12 (33%) eyes. There were no ocular or systemic adverse events.

Conclusions: Continuous monthly intravitreal ranibizumab is safe and well tolerated in eyes with PCV. Preliminary results show stabilisation of vision, resolution of subretinal haemorrhage and a decrease in macular oedema. Polypoidal lesions decreased in 4/12 (33%) eyes, but branching choroidal vessels persisted.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage*
  • Angiogenesis Inhibitors / therapeutic use
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Choroid Diseases / complications
  • Choroid Diseases / drug therapy*
  • Choroid Diseases / pathology
  • Drug Administration Schedule
  • Female
  • Fluorescein Angiography
  • Fovea Centralis / pathology
  • Humans
  • Injections, Intraocular
  • Macular Edema / etiology
  • Male
  • Middle Aged
  • Prospective Studies
  • Ranibizumab
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Vision Disorders / etiology
  • Vision Disorders / physiopathology
  • Vision Disorders / prevention & control
  • Visual Acuity / drug effects

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Ranibizumab