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Clinical science
Long-term results of photodynamic therapy or ranibizumab for polypoidal choroidal vasculopathy in LAPTOP study
  1. Noriko Miyamoto1,2,
  2. Michiko Mandai1,3,
  3. Akio Oishi2,
  4. Shunichiro Nakai4,
  5. Shigeru Honda4,
  6. Takafumi Hirashima5,
  7. Hideyasu Oh5,
  8. Yoshiko Matsumoto6,
  9. Mamoru Uenishi6,
  10. Yasuo Kurimoto1,2
  1. 1 Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan
  2. 2 Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Japan
  3. 3 Laboratory for Retinal Regeneration, RIKEN Center for Developmental Biology, Kobe, Japan
  4. 4 Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
  5. 5 Department of Ophthalmology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
  6. 6 Department of Ophthalmology, Mitsubishi Kobe Hospital, Kobe, Japan
  1. Correspondence to Dr Noriko Miyamoto, Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan; miyacy_fr{at}hotmail.com

Abstract

Background/aim We previously reported that ranibizumab performed better on visual prognosis than photodynamic therapy (PDT) in a Ranibizumab (Lucentis) And Photodynamic Therapy On Polypoidal choroidal vasculopathy (LAPTOP) study. To determine if the first-choice treatment, either PDT or intravitreal ranibizumab, has a long-term effect in patients with polypoidal choroidal vasculopathy (PCV).

Methods We reviewed medical records of patientsrandomised to either PDT (29 eyes) or ranibizumab (27 eyes) from July 2009 to June 2011 in LAPTOP study. Retreatment or switching to other treatments were at the investigator’s discretion after release from the 2-year LAPTOP study up to 5years. We evaluated visual acuity (VA), continuity of initial treatment, percentage of dry macula achievement and macular atrophy at 5 years.

Results The logarithm of minimal angle of resolution VA was 0.56 in the PDT and 0.44 in the ranibizumab groups at baseline (p=0.101) and was 0.55 and 0.28 at 5years, respectively (p<0.05). More than 70% of the patients converted to aflibercept in following years. Achievement percentages of dry macula were 74% (PDT) and 63% (ranibizumab) at 5years, and macular atrophy was detected in 78% (PDT) and 60% (ranibizumab) with a mean area of 7.7 and 3.5 mm2, respectively (p=0.155).

Conclusions The better VA in the initial ranibizumab group compared with the PDT group at 2 years was retained at the 5-year follow-up.

  • Macula
  • Degeneration

https://doi.org/10.1136/bjophthalmol-2018-312419

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    Footnotes

    • Contributors NM, MM, AO and SH designed the study. All the authors collected the data. NM, MM and SH analysed and interpreted the data, and NM wrote the initial draft of the manuscript which was critically reviewed by all the coauthors. All authors approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval Institutional Review Board and Ethics Committee of the Kobe City Medical Center General Hospital.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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