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Results of 2 years of treatment with as-needed ranibizumab reinjection for polypoidal choroidal vasculopathy
  1. Taiichi Hikichi,
  2. Makoto Higuchi,
  3. Takuro Matsushita,
  4. Shoko Kosaka,
  5. Reiko Matsushita,
  6. Kimitaka Takami,
  7. Hideo Ohtsuka,
  8. Hirokuni Kitamei,
  9. Shoko Shioya
  1. Department of Ophthalmology, Ohtsuka Eye Hospital, Sapporo, Japan
  1. Correspondence to Dr Taiichi Hikichi, Department of Ophthalmology, Ohtsuka Eye Hospital, Kita-16 Nishi-4, Kita-ku, Sapporo 001-0016, Japan; taiichi-hikichi{at}


Purpose To investigate the 2-year outcomes of three monthly intravitreal ranibizumab injections followed by as-needed reinjections to treat polypoidal choroidal vasculopathy (PCV).

Methods Seventy-five consecutive eyes with naïve symptomatic PCV with 2 years of follow-up after treatment were studied prospectively.

Results The mean (±SD) numbers of injections were 4.2±1.3 that included three monthly injections in the loading phase and 1.6±1.7 during years 1 and 2, respectively (mean 2-year total, 5.6±1.9). The baseline logarithm of the minimum angle of resolution visual acuity (VA) was 0.59±0.51 that improved significantly (p=0.001 for both comparisons) to 0.37±0.33 and 0.41±0.40 at 1 and 2 years, respectively, after the first injection. Although no significant difference was found between years 1 and 2 after the first injection, the VA tended to decrease slightly during year 2. The improved foveal thickness was maintained during year 2. Thirty (40%) eyes and 19 (25%) eyes, respectively, at years 1 and 2 after the first injection had no polypoidal lesions on indocyanine green angiography. A branching vascular network (BVN) remained in all eyes 2 years after the first injection and tended to increase in size during year 2.

Conclusions The 2-year outcomes showed significant VA and foveal thickness improvements in eyes with PCV. During year 2, the magnitude of the improvement was lower compared with year 1. An as-needed reinjection schedule might not prevent polypoidal lesions or BVNs from regrowing. Further investigations should establish a treatment strategy for PCV.

  • Macula
  • Treatment Medical

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