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Combination anti-VEGF, PDT may resolve PCV in eyes with neovascular AMD
The prevalence of polypoidal choroidal vasculopathy was elevated in Caucasian patients with presumed neovascular age-related macular degeneration who responded poorly to ranibizumab monotherapy. In eyes with PCV, combination therapy cleared PCV and stabilized visual acuity, according to a study.
The retrospective study included 202 eyes of 180 patients who underwent intravitreal injections of Lucentis 0.5 mg (ranibizumab, Genentech). Patients received three consecutive monthly injections. Those showing evidence of choroidal neovascularization, intraretinal or subretinal fluid, or macular hemorrhage more than 1 month after the last injection were re-treated as needed.
The analysis included only patients who received eight or more injections and underwent re-evaluation for polypoidal choroidal vasculopathy (PCV) with indocyanine green angiography.
The patient group as a whole received a mean 12.8 injections over 27.8 months. The interval between the first and sixth injection was less than 12 months in 149 eyes (first group) and more than 12 months in 53 eyes (second group).
Sixteen of 34 eyes diagnosed with PCV underwent combination photodynamic therapy/ranibizumab therapy augmented with ranibizumab monotherapy as needed.
The overall prevalence of PCV was 16.8%. The prevalence of PCV was 21.5% in the first group and 3.8% in the second group; the between-group difference was statistically significant (P = .003).
Sixteen eyes with PCV received 3.1 injections after commencement of combination therapy, as opposed to 8.4 injections before combination therapy (P < .001). Visual acuity stabilized, and PCV resolved in those eyes.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.