One-Year Results of Three Monthly Ranibizumab Injections and As-Needed Reinjections for Polypoidal Choroidal Vasculopathy in Japanese Patients

PURPOSE: To investigate the 1-year outcomes of monthly intravitreal injections of ranibizumab for 3 months followed by an as-needed reinjection schedule to treat polypoidal choroidal vasculopathy (PCV) in Japanese patients. DESIGN: Prospective, consecutive case series. METHODS: Eighty-five eyes of 82 consecutive Japanese patients with naive symptomatic PCV received monthly intravitreal injections of ranibizumab for 3 months followed by an as-needed reinjection schedule. Eighty-one eyes (95%) followed for 1 year were studied. RESULTS: A mean of 4.2 +/- 1.3 (mean +/- standard deviation) injections were administered over 1 year. Twenty-three of 81 eyes (28%) did not require additional injections and 32 eyes (40%) required only 1 injection after the 3 monthly injections. The mean (+/- standard error) logarithm of minimal angle of resolution (logMAR) visual acuity (VA) at baseline was 0.59 +/- 0.37 and improved to 0.37 +/- 0.30 (P = .001). Thirty eyes (37%) and 5 eyes (6%), respectively, had improved and decreased VA of 0.3 or more logMAR unit. Indocyanine green angiography showed that the polypoidal lesions resolved in 21 eyes (26%) and 32 eyes (40%) 3 months and 1 year after the first injection, respectively. Abnormal choroidal vessels remained in all eyes. CONCLUSIONS: Monthly injections of ranibizumab for 3 months to treat PCV improved the VA, and a reinjection schedule based on need maintained the improved VA. The polypoidal lesions tended to improve over 1 year, whereas abnormal choroidal vessels remained in all eyes. Further long-term follow-up is needed to determine the efficacy of ranibizumab therapy for PCV. (Am J Ophthalmol 2012;154:117-124. (C) 2012 by Elsevier Inc. All rights reserved.)