Factors associated with polyp regression after intravitreal ranibizumab injections for polypoidal choroidal vasculopathy

Han Joo Cho, Sang Yoon Han, Hyoung Seok Kim, Tae Gon Lee, Jong Woo Kim
Japanese Journal of Ophthalmology 2015, 59 (1): 29-35

PURPOSE: To investigate the predictive factors of polyp regression after intravitreal ranibizumab injections for polypoidal choroidal vasculopathy (PCV).

METHODS: Sixty-nine eyes (69 patients) with treatment-naïve PCV received an initial series of 3-monthly intravitreal ranibizumab injections, followed by as-needed injections. Polyp regression was determined after 6 months from baseline by means of indocyanine angiography and correlated with clinical characteristics at baseline.

RESULTS: After treatment, 26.1% (18 out of 69 eyes) achieved complete polyp regression and 73.9% (51 out of 69 eyes) showed persistent polyps. The mean logarithm of the minimum angle of resolution (logMAR) of best-corrected visual acuity (BCVA) was significantly improved in both groups (P = 0.02). No statistically significant difference in BCVA improvement was observed between the groups. However, the proportion of subjects with BCVA improvement by more than three lines was significantly higher in the polyp regression group (P = 0.02). Univariate analysis of the baseline characteristics identified the number of polyps (P = 0.02), the total polyp area (P = 0.009) and the polyp pattern (P = 0.01) as predictive factors for polyp regression. Multivariate logistic regression identified the total polyp area (P = 0.01) as an independent predictor for polyp regression after intravitreal ranibizumab injections.

CONCLUSIONS: The regression of polypoidal lesions in PCV patients after intravitreal ranibizumab injections was associated with a smaller total polyp area. This result could be helpful in predicting polypoidal changes after ranibizumab treatment and in deciding the best treatment strategy for PCV patients.

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