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SWITCHING TO INTRAVITREAL AFLIBERCEPT INJECTION FOR POLYPOIDAL CHOROIDAL VASCULOPATHY REFRACTORY TO RANIBIZUMAB

Saito, Masaaki MD, PhD; Kano, Mariko MD; Itagaki, Kanako MD; Oguchi, Yasuharu MD, PhD; Sekiryu, Tetsuju MD, PhD

doi: 10.1097/IAE.0000000000000236
Original Study

Purpose: To clarify the efficacy of switching to intravitreal aflibercept injection to treat polypoidal choroidal vasculopathy refractory to ranibizumab.

Methods: In this retrospective study, 43 eyes of 42 patients (mean age, 76.5 years) with polypoidal choroidal vasculopathy treated with aflibercept (2 mg/0.05 mL) were reviewed. A treatment history of 3 consecutive monthly intravitreal injections of ranibizumab as an induction phase followed by a pro re nata maintenance phase over 12 months was seen for all patients. All patients who were refractory to ranibizumab (defined as having persist subretinal or intraretinal fluid by optical coherence tomography and unchanged or decreased visual acuity compared with the time of the first ranibizumab injection, despite receiving the last 3 consecutive monthly intravitreal ranibizumab injections after 12 months).

Results: The mean logarithm of the minimum angle of resolution best-corrected visual acuity levels (Snellen equivalent) improved significantly (P = 0.0074) from 0.38 (20/48) at baseline to 0.34 (20/43) 3 months after switching to aflibercept (Month 3) (mean best-corrected visual acuity improvement, 0.47 line). The central retinal thickness decreased significantly (P < 0.0001) from 245 μm at baseline to 131 μm at Month 3. Of 30 eyes with polypoidal lesions at baseline, the polypoidal lesions regressed completely in 15 eyes (50%) at Month 3.

Conclusion: Administering intravitreal aflibercept injection for patients with polypoidal choroidal vasculopathy refractory to ranibizumab maintained or improved visual acuity and reduced or eliminated exudative lesions and occluding polypoidal lesions without adverse events with short-term follow-up.

In polypoidal choroidal vasculopathy refractory to ranibizumab, switching to intravitreal aflibercept injection maintained and improved visual acuity. The polypoidal choroidal vasculopathy resolved completely in 50% of eyes 3 months after treatment.

Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan.

Reprint requests: Masaaki Saito, MD, PhD, Department of Ophthalmology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; e-mail: smasaaki@fmu.ac.jp

None of the authors have any financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.