Continuous anti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy: 6-month results

Aim To evaluate the short-term efficacy and safety of monthly intravitreal injections of ranibizumab in patients with polypoidal choroidal vasculopathy (PCV) and active exudation or haemorrhage. Methods A prospective, open-label trial of monthly intravitreal ranibizumab (0.5 mg) injections for PCV in 12 eyes of 12 patients was performed. The primary outcome measures were stabilisation of vision (loss < 15 ETDRS letters). Secondary outcome measures included incidence of ocular and systemic adverse events, and changes in subretinal haemorrhage, central foveal thickness (CFT) and polypoidal complexes on indocyanine green angiography at 6 months. Results Baseline findings included eight eyes with subretinal fluid, six eyes with subretinal haemorrhage and five eyes with macular oedema (CFT > 275 mu m). No patient lost >= 15 letters in visual acuity at 6 months. Subretinal fluid decreased in 5/8 eyes (63%). Subretinal haemorrhage resolved in 6/6 eyes (100%). Macular oedema improved in 4/5 eyes (80%). Polypoidal complexes decreased in 4/12 (33%) eyes. There were no ocular or systemic adverse events. Conclusions Continuous monthly intravitreal ranibizumab is safe and well tolerated in eyes with PCV. Preliminary results show stabilisation of vision, resolution of subretinal haemorrhage and a decrease in macular oedema. Polypoidal lesions decreased in 4/12 (33%) eyes, but branching choroidal vessels persisted.