Continuous Anti-VEGF Treatment with Ranibizumab for Polypoidal Choroidal Vasculopathy: 6-month Results

Aim: To evaluate the short-term efficacy and safety of monthly intravitreal injections of ranibizumab in patients with polypoidal choroidal vasculopathy (PCV) and active exudation or haemorrhage.

Methods: A prospective, open-label trial of monthly intravitreal ranibizumab (0.5 mg) injections for PCV in 12 eyes of 12 patients was performed. The primary outcome measures were stabilisation of vision (loss <15 ETDRS letters). Secondary outcome measures included incidence of ocular and systemic adverse events, and changes in subretinal haemorrhage, central foveal thickness (CFT) and polypoidal complexes on indocyanine green angiography at 6 months.

Results: Baseline findings included eight eyes with subretinal fluid, six eyes with subretinal haemorrhage and five eyes with macular oedema (CFT >275 microm). No patient lost > or = 15 letters in visual acuity at 6 months. Subretinal fluid decreased in 5/8 eyes (63%). Subretinal haemorrhage resolved in 6/6 eyes (100%). Macular oedema improved in 4/5 eyes (80%). Polypoidal complexes decreased in 4/12 (33%) eyes. There were no ocular or systemic adverse events.

Conclusions: Continuous monthly intravitreal ranibizumab is safe and well tolerated in eyes with PCV. Preliminary results show stabilisation of vision, resolution of subretinal haemorrhage and a decrease in macular oedema. Polypoidal lesions decreased in 4/12 (33%) eyes, but branching choroidal vessels persisted.