Polypoidal choroidal vasculopathy with multiple polyps has poorer response to ranibizumab

Issue: June 2016

Polypoidal choroidal vasculopathy with multiple polyps did not respond as well to intravitreal ranibizumab as polypoidal choroidal vasculopathy with a single polyp, according to a study conducted in Japan.

“We propose that the stratification of PCV lesions by polyp number may be valuable to understand the prognosis of this condition,” the study authors said.

The retrospective case series included 48 treatment-naïve eyes of 48 patients who underwent intravitreal Lucentis (ranibizumab, Genentech) monotherapy between 2009 and 2013.

Twenty-nine eyes of 29 patients had a single polyp, and 19 eyes of 19 patients had multiple polyps. Patients received three monthly ranibizumab injections followed by as-needed injections.

Best corrected visual acuity was maintained or improved in 28 of 29 eyes in the single polyp group and in 14 of 19 eyes in the multiple polyps group at 1 year. The between-group difference was statistically significant (P = .019).

At 2 years, BCVA was maintained or improved in 21 of 27 eyes in the single polyp group and in 13 of 16 eyes in the multiple polyps group. The difference was not statistically significant.

At 1 year, mean central retinal thickness was 297.5 µm in the multiple polyps group and 226.6 µm in the single polyp group; the difference was statistically significant (P = .009). Mean change in central retinal thickness was 101.2 µm in the multiple polyps group and 168 µm in the single polyp group; the difference was significant (P = .042).

The mean number of injections required before complete disappearance of intraretinal and subretinal exudative changes and attainment of a dry macula was 3.4 in the single polyp group and 4.9 in the multiple polyps group.

Disclosures: Suzuki reports a financial relationship with Pfizer Japan Inc. and Novartis Pharmaceuticals Japan. See the study for a full list of all other authors’ relevant financial disclosures.

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Source:

Suzuki M, et al. Am J Ophthalmol. 2016;doi:10.1016/j.ajo.2016.03.024.