title: Responsiveness of eyes with polypoidal choroidal vasculopathy with choroidal hyperpermeability to intravitreal ranibizumab.
abstract: BACKGROUND
  To determine the role played by vascular endothelial growth factor (VEGF) in polypoidal choroidal vasculopathy (PCV) based on an interventional immunology theory.
  
  
  METHODS
  Eyes with PCV were divided in a masked fashion into those with choroidal hyperpermeability (HP group) and those with normal choroidal permeability (NP group) based on the indocyanine green angiograms. The inter-rater agreement rate was evaluated using Fleiss' kappa. Patients were treated by intravitreal ranibizumab (IVB). The central choroidal thickness and central foveal thickness (CFT) at the baseline and 7 days after the treatment were measured by optical coherence tomography.
  
  
  RESULTS
  Among the 57 consecutive eyes diagnosed with PCV, 42 eyes of 42 patients met the inclusion criteria (21 eyes/HP group vs 21 eyes /NP group). Central choroidal thickness in HP group was significantly thicker than that in the NP group (P < .001, Mann-Whitney U test). The inter-rater agreement was high with a Fleiss' kappa = 0.95, P < .0001. The percentage reduction in the CFT in HP group (14.0%) was significantly less than that in NP group (20.4%; P = .013, Mann-Whitney U test).
  
  
  CONCLUSIONS
  Eyes with PCV that are associated with choroidal hyper-permeability may not be strongly associated with VEGF-related pathology, and may not respond favorably to anti-VEGF monotherapy.
authors: Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. tsakamot@m3.kufm.kagoshima-u.ac.jp.
authors: Shozo
authors: S
authors: Sonoda
authors: Taiji
authors: T
authors: Sakamoto
authors: Hiroki
authors: H
authors: Otsuka
authors: Narimasa
authors: N
authors: Yoshinaga
authors: Toshifumi
authors: T
authors: Yamashita
authors: Yuya
authors: Y
authors: Ki-I
authors: Akiko
authors: A
authors: Okubo
authors: Takehiro
authors: T
authors: Yamashita
authors: Noboru
authors: N
authors: Arimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D002199:Capillary Permeability; D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000069579:Ranibizumab; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab
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