Individualized ranibizumab therapy strategies in year 3 after as-needed treatment for polypoidal choroidal vasculopathy

摘要

Background To investigate the third-year results of ranibizumab monotherapy for polypoidal choroidal vasculopathy (PCV) in individualized treatment regimens based on the outcomes during 2?years. Methods One hundred seventy-two consecutive eyes of 163 prospective treatment-na?ve patients with PCV were treated with three monthly intravitreal ranibizumab injections followed by as-needed reinjections and completed a 2-year follow-up. Treatment regimens during the third year were selected individually based on their outcomes from the following treatment regimens: as-needed injections based on quarterly examinations, as-needed injections based on monthly examinations, a monthly ranibizumab injection schedule, and the treat-and-extend schedule. Visual acuity (VA) and foveal thickness at the end of the third year and the prevalence of discontinuous follow-up examinations during the third year were evaluated. Results Of 163 patients, 35 (21%) patients were excluded; nine patients had discontinuous follow-up examinations during the third year. In 128 eyes of 128 patients studied during the third year, the significant improvements in VA and foveal thickness 2?years after the first injection compared to baseline were maintained at the end of the third year. Six (18%, 6/34) patients treated with as-needed injections based on quarterly examinations had discontinuous follow-up examinations, the prevalence of which differed significantly (P?=?0.025) from the other groups. Conclusions The individualized treatment strategies in the third year based on each patient’s outcomes during 2?years maintained the improved VA and avoided discontinuation of follow-up during the third year.