title: Intravitreal aflibercept for polypoidal choroidal vasculopathy after developing ranibizumab tachyphylaxis.
abstract: OBJECTIVE
  To evaluate the effect of aflibercept treatment after developing ranibizumab tachyphylaxis for the treatment of polypoidal choroidal vasculopathy (PCV).
  
  
  METHODS
  Ten eyes from ten patients with PCV who developed ranibizumab tachyphylaxis were reviewed. Tachyphylaxis was defined as when repeated intravitreal ranibizumab (IVR) resulted in a complete lack of response after initial treatment response. All treatments were converted to intravitreal aflibercept (IVA) after development of ranibizumab tachyphylaxis. Central retinal thickness (CRT) was compared at baseline, at complete resolution after IVR, at reactivation after IVR, at initial IVA, and at 4 and 12 weeks after initial IVA.
  
  
  RESULTS
  Mean number of IVR treatments before conversion to IVA was 11.3 (range 5-16). All eyes had positive therapeutic responses after conversion to IVA. Mean CRT at 4 and 12 weeks after initial IVA was significantly decreased from baseline initial IVA (P = 0.005).
  
  
  CONCLUSIONS
  Switching therapy to aflibercept is effective for patients with PCV who develop tachyphylaxis to ranibizumab.
authors: Department of Ophthalmology, Tokyo Medical University, Ibaraki Medical Center, Ami, Ibaraki, Japan ; Department of Ophthalmology, Tokyo Medical University, Nishi-Shinjuku, Tokyo, Japan.
authors: Masahiro
authors: M
authors: Miura
authors: Takuya
authors: T
authors: Iwasaki
authors: Hiroshi
authors: H
authors: Goto
keywords: aflibercept; polypoidal choroidal vasculopathy; ranibizumab; tachyphylaxis
references: N Engl J Med. 2006 Oct 5;355(14):1419-31
references: 17021318
references: Am J Ophthalmol. 2012 Jul;154(1):117-124.e1
references: 22465366
references: Ophthalmology. 2008 Jan;115(1):141-6
references: 17582498
references: Prog Retin Eye Res. 2010 Jan;29(1):19-29
references: 19854291
references: Jpn J Ophthalmol. 2011 Jan;55(1):39-44
references: 21331691
references: Ophthalmology. 2009 Jan;116(1):57-65.e5
references: 19118696
references: Invest Ophthalmol Vis Sci. 2003 Jul;44(7):3186-93
references: 12824270
references: Ophthalmology. 2012 Dec;119(12):2537-48
references: 23084240
references: Eye (Lond). 2013 May;27(5):663-7; quiz 668
references: 23558214
references: Br J Ophthalmol. 2013 May;97(5):617-21
references: 23428984
references: Angiogenesis. 2008;11(2):109-19
references: 18293091
references: Br J Ophthalmol. 2008 May;92(5):667-8
references: 18356264
references: Br J Ophthalmol. 2012 Jan;96(1):21-3
references: 21733918
references: Ophthalmologica. 2012;227 Suppl 1:2-10
references: 22517120
references: Angiogenesis. 2012 Jun;15(2):171-85
references: 22302382
references: Proc Natl Acad Sci U S A. 2009 Apr 14;106(15):6152-7
references: 19369214
references: Retina. 1990;10(1):1-8
references: 1693009
references: Br J Ophthalmol. 2010 Jan;94(1):2-13
references: 19443462
references: Br J Ophthalmol. 2012 Jan;96(1):14-20
references: 21791509
references: Science. 1989 Dec 8;246(4935):1306-9
references: 2479986
references: Br J Ophthalmol. 2012 Jan;96(1):1-2
references: 22157632