Combination therapy with focal laser photocoagulation and intravitreal ranibizumab for polypoidal choroidal vasculopathy: a case series

Eur J Ophthalmol. 2012 Nov-Dec;22(6):1001-7. doi: 10.5301/ejo.5000135. Epub 2012 Mar 20.

Abstract

Purpose: The study aim is to describe the clinical outcomes of patients with polypoidal choroidal vasculopathy (PCV) treated with focal argon laser photocoagulation and ranibizumab combination therapy.

Methods: This study is a retrospective case series of 6 patients (6 eyes) diagnosed with PCV who received combination therapy with argon laser photocoagulation and ranibizumab and have at least 12 months follow-up. Argon laser photocoagulation was applied directly to the polypoidal lesions as identified on indocyanine green angiography and followed by a course of intravitreal ranibizumab injections. The primary outcome measures were the mean change in logMAR visual acuity and the mean change in central macular thickness (CMT) at final follow-up.

Results: The mean (SD) duration of follow-up was 1.09 (0.22) years. At the final follow-up the difference (95% confidence interval [CI]) in logMAR acuity was 0.48 (0.10-0.74) (p=0.01) and the difference (95% CI) in CMT was 207 µm (35-490) (p=0.02) on optical coherence tomography. The mean (SD) number of ranibizumab injections per eye was 4.83 (3.6). The mean (SD) number of laser treatments per eye was 1.16 (0.4).

Conclusions: In this study, combination therapy with focal argon laser photocoagulation and intravitreal ranibizumab resulted in improved visual acuity and clinical outcomes for patients with PCV for up to 1 year.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use*
  • Choroidal Neovascularization / drug therapy
  • Choroidal Neovascularization / physiopathology
  • Choroidal Neovascularization / surgery
  • Choroidal Neovascularization / therapy*
  • Combined Modality Therapy
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections
  • Laser Coagulation*
  • Lasers, Gas / therapeutic use
  • Male
  • Middle Aged
  • Polyps / drug therapy
  • Polyps / physiopathology
  • Polyps / surgery
  • Polyps / therapy*
  • Ranibizumab / therapeutic use*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology

Substances

  • Angiogenesis Inhibitors
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Ranibizumab