title: Switching to intravitreal aflibercept injection for polypoidal choroidal vasculopathy refractory to ranibizumab.
abstract: OBJECTIVE
  To clarify the efficacy of switching to intravitreal aflibercept injection to treat polypoidal choroidal vasculopathy refractory to ranibizumab.
  
  
  METHODS
  In this retrospective study, 43 eyes of 42 patients (mean age, 76.5 years) with polypoidal choroidal vasculopathy treated with aflibercept (2 mg/0.05 mL) were reviewed. A treatment history of 3 consecutive monthly intravitreal injections of ranibizumab as an induction phase followed by a pro re nata maintenance phase over 12 months was seen for all patients. All patients who were refractory to ranibizumab (defined as having persist subretinal or intraretinal fluid by optical coherence tomography and unchanged or decreased visual acuity compared with the time of the first ranibizumab injection, despite receiving the last 3 consecutive monthly intravitreal ranibizumab injections after 12 months).
  
  
  RESULTS
  The mean logarithm of the minimum angle of resolution best-corrected visual acuity levels (Snellen equivalent) improved significantly (P = 0.0074) from 0.38 (20/48) at baseline to 0.34 (20/43) 3 months after switching to aflibercept (Month 3) (mean best-corrected visual acuity improvement, 0.47 line). The central retinal thickness decreased significantly (P < 0.0001) from 245 μm at baseline to 131 μm at Month 3. Of 30 eyes with polypoidal lesions at baseline, the polypoidal lesions regressed completely in 15 eyes (50%) at Month 3.
  
  
  CONCLUSIONS
  Administering intravitreal aflibercept injection for patients with polypoidal choroidal vasculopathy refractory to ranibizumab maintained or improved visual acuity and reduced or eliminated exudative lesions and occluding polypoidal lesions without adverse events with short-term follow-up.
authors: Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors: Masaaki
authors: M
authors: Saito
authors: Mariko
authors: M
authors: Kano
authors: Kanako
authors: K
authors: Itagaki
authors: Yasuharu
authors: Y
authors: Oguchi
authors: Tetsuju
authors: T
authors: Sekiryu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D015862:Choroid Diseases / Q000188:drug therapy*; D057915:Drug Substitution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000188:drug therapy*; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab