Distinct Responsiveness to Intravitreal Ranibizumab Therapy in Polypoidal Choroidal Vasculopathy with Single or Multiple Polyps

Misa Suzuki, Norihiro Nagai, Hajime Shinoda, Atsuro Uchida, Toshihide Kurihara, Yohei Tomita, Mamoru Kamoshita, Chigusa Iyama, Kazuo Tsubota, Yoko Ozawa

Research output: Contribution to journalArticle

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Abstract

Purpose: To understand the prognosis of polypoidal choroidal vasculopathy (PCV) by evaluating the responsiveness to intravitreal ranibizumab (IVR) monotherapy according to the presence of a single or multiple polyps. Design: Retrospective case series. Methods: We included 48 treatment-naïve eyes of 48 patients who received IVR monotherapy at the Medical Retina Division Clinic, Keio University Hospital between March 2009 and January 2013 and attended the clinic for at least 12 months. All patients received 3 monthly IVR injections followed by pro re nata injections and were divided into single polyp and multiple polyps groups according to indocyanine green angiography and optical coherence tomography (OCT) findings. The outcome measures included changes in best-corrected visual acuity (BCVA) and OCT findings over 2 years after initial IVR. Results: At baseline, the multiple polyps group exhibited a poorer BCVA, larger greatest linear dimension, and higher prevalence of fibrovascular pigment epithelial detachment compared with the single polyp group. Over 2 years, the multiple polyps group showed no improvement in BCVA, although the central retinal thickness (CRT) decreased in both groups. The multiple polyps group exhibited a significantly greater CRT at 1 year and required more injections in the first year compared with the single polyp group; furthermore, it included a higher number of nonresponders judged either by BCVA or fundus findings at 1 year and fundus findings at 2 years. Conclusions: We propose that the stratification of PCV lesions according to the presence of single or multiple polyps may be valuable to understand the prognosis.

Original languageEnglish
Pages (from-to)52-59
Number of pages8
JournalAmerican Journal of Ophthalmology
Volume166
DOIs
Publication statusPublished - 2016 Jun 1

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Polyps
Visual Acuity
Therapeutics
Optical Coherence Tomography
Ranibizumab
Intravitreal Injections
Injections
Indocyanine Green
Retina
Angiography
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Distinct Responsiveness to Intravitreal Ranibizumab Therapy in Polypoidal Choroidal Vasculopathy with Single or Multiple Polyps. / Suzuki, Misa; Nagai, Norihiro; Shinoda, Hajime; Uchida, Atsuro; Kurihara, Toshihide; Tomita, Yohei; Kamoshita, Mamoru; Iyama, Chigusa; Tsubota, Kazuo; Ozawa, Yoko.

In: American Journal of Ophthalmology, Vol. 166, 01.06.2016, p. 52-59.

Research output: Contribution to journalArticle

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abstract = "Purpose: To understand the prognosis of polypoidal choroidal vasculopathy (PCV) by evaluating the responsiveness to intravitreal ranibizumab (IVR) monotherapy according to the presence of a single or multiple polyps. Design: Retrospective case series. Methods: We included 48 treatment-na{\"i}ve eyes of 48 patients who received IVR monotherapy at the Medical Retina Division Clinic, Keio University Hospital between March 2009 and January 2013 and attended the clinic for at least 12 months. All patients received 3 monthly IVR injections followed by pro re nata injections and were divided into single polyp and multiple polyps groups according to indocyanine green angiography and optical coherence tomography (OCT) findings. The outcome measures included changes in best-corrected visual acuity (BCVA) and OCT findings over 2 years after initial IVR. Results: At baseline, the multiple polyps group exhibited a poorer BCVA, larger greatest linear dimension, and higher prevalence of fibrovascular pigment epithelial detachment compared with the single polyp group. Over 2 years, the multiple polyps group showed no improvement in BCVA, although the central retinal thickness (CRT) decreased in both groups. The multiple polyps group exhibited a significantly greater CRT at 1 year and required more injections in the first year compared with the single polyp group; furthermore, it included a higher number of nonresponders judged either by BCVA or fundus findings at 1 year and fundus findings at 2 years. Conclusions: We propose that the stratification of PCV lesions according to the presence of single or multiple polyps may be valuable to understand the prognosis.",
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AU - Uchida, Atsuro

AU - Kurihara, Toshihide

AU - Tomita, Yohei

AU - Kamoshita, Mamoru

AU - Iyama, Chigusa

AU - Tsubota, Kazuo

AU - Ozawa, Yoko

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