title: Results of 2 years of treatment with as-needed ranibizumab reinjection for polypoidal choroidal vasculopathy.
abstract: OBJECTIVE
  To investigate the 2-year outcomes of three monthly intravitreal ranibizumab injections followed by as-needed reinjections to treat polypoidal choroidal vasculopathy (PCV).
  
  
  METHODS
  Seventy-five consecutive eyes with naïve symptomatic PCV with 2 years of follow-up after treatment were studied prospectively.
  
  
  RESULTS
  The mean (±SD) numbers of injections were 4.2±1.3 that included three monthly injections in the loading phase and 1.6±1.7 during years 1 and 2, respectively (mean 2-year total, 5.6±1.9). The baseline logarithm of the minimum angle of resolution visual acuity (VA) was 0.59±0.51 that improved significantly (p=0.001 for both comparisons) to 0.37±0.33 and 0.41±0.40 at 1 and 2 years, respectively, after the first injection. Although no significant difference was found between years 1 and 2 after the first injection, the VA tended to decrease slightly during year 2. The improved foveal thickness was maintained during year 2. Thirty (40%) eyes and 19 (25%) eyes, respectively, at years 1 and 2 after the first injection had no polypoidal lesions on indocyanine green angiography. A branching vascular network (BVN) remained in all eyes 2 years after the first injection and tended to increase in size during year 2.
  
  
  CONCLUSIONS
  The 2-year outcomes showed significant VA and foveal thickness improvements in eyes with PCV. During year 2, the magnitude of the improvement was lower compared with year 1. An as-needed reinjection schedule might not prevent polypoidal lesions or BVNs from regrowing. Further investigations should establish a treatment strategy for PCV.
authors: Department of Ophthalmology, Ohtsuka Eye Hospital, Kita-16 Nishi-4, Kita-ku, Sapporo 001-0016, Japan. taiichi-hikichi@hokkaido.med.or.jp
authors: Taiichi
authors: T
authors: Hikichi
authors: Makoto
authors: M
authors: Higuchi
authors: Takuro
authors: T
authors: Matsushita
authors: Shoko
authors: S
authors: Kosaka
authors: Reiko
authors: R
authors: Matsushita
authors: Kimitaka
authors: K
authors: Takami
authors: Hideo
authors: H
authors: Ohtsuka
authors: Hirokuni
authors: H
authors: Kitamei
authors: Shoko
authors: S
authors: Shioya
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002829:Choroid / Q000098:blood supply; D015862:Choroid Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008297:Male; D011127:Polyps / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D000069579:Ranibizumab; D019233:Retreatment; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D007208:Indocyanine Green; D000069579:Ranibizumab