title: Individualized ranibizumab therapy strategies in year 3 after as-needed treatment for polypoidal choroidal vasculopathy.
abstract: BACKGROUND
  To investigate the third-year results of ranibizumab monotherapy for polypoidal choroidal vasculopathy (PCV) in individualized treatment regimens based on the outcomes during 2 years.
  
  
  METHODS
  One hundred seventy-two consecutive eyes of 163 prospective treatment-naïve patients with PCV were treated with three monthly intravitreal ranibizumab injections followed by as-needed reinjections and completed a 2-year follow-up. Treatment regimens during the third year were selected individually based on their outcomes from the following treatment regimens: as-needed injections based on quarterly examinations, as-needed injections based on monthly examinations, a monthly ranibizumab injection schedule, and the treat-and-extend schedule. Visual acuity (VA) and foveal thickness at the end of the third year and the prevalence of discontinuous follow-up examinations during the third year were evaluated.
  
  
  RESULTS
  Of 163 patients, 35 (21%) patients were excluded; nine patients had discontinuous follow-up examinations during the third year. In 128 eyes of 128 patients studied during the third year, the significant improvements in VA and foveal thickness 2 years after the first injection compared to baseline were maintained at the end of the third year. Six (18%, 6/34) patients treated with as-needed injections based on quarterly examinations had discontinuous follow-up examinations, the prevalence of which differed significantly (P = 0.025) from the other groups.
  
  
  CONCLUSIONS
  The individualized treatment strategies in the third year based on each patient's outcomes during 2 years maintained the improved VA and avoided discontinuation of follow-up during the third year.
authors.affiliation: Ohtsuka Eye Hospital, Kita-16 Nishi-4, Kita-ku, Sapporo, 001-0016, Japan. taiichi-hikichi@hokkaido.med.or.jp.
authors.forename: Taiichi
authors.initials: T
authors.lastname: Hikichi
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D002829:Choroid / Q000098:blood supply* / Q000473:pathology; D015862:Choroid Diseases / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D011446:Prospective Studies; D000069579:Ranibizumab / Q000008:administration & dosage*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D000069579:Ranibizumab