A team of researchers recently found that treating patients who have polypoidal choroidal vasculopathy with intravitreal anti-vascular endothelial growth factor (anti-VEGF) ranibizumab produced better visual results than photodynamic therapy (PDT) did over a five-year period.

The research—a follow-up to a two-year study of the two treatment options—included 29 eyes that received PDT and 27 that received ranibizumab. The researchers evaluated visual acuity (VA), continuity of initial treatment, percentage of dry macula achievement and macular atrophy after five years. Treatment changes were at the investigator's discretion after the initial two-year study period.

The team found VA was 0.56logMAR and 0.44logMAR at baseline and 0.55logMAR and 0.28logMAR at five years in the PDT and ranibizumab groups, respectively. The achievement percentages of dry macula were 74% (PDT) and 63% (ranibizumab) at five years and macular atrophy was detected in 78% (PDT) and 60% (ranibizumab) of eyes with mean areas of 7.7mm2 (PDT) and 3.5mm2 (ranibizumab).

Although those who began treatment with ranibizumab showed improved outcomes compared with the initial PDT group, the researchers note that more than 70% of the patients eventually converted to aflibercept.

Miyamoto N, Mandai M, Oishi A, et al. Five-year outcomes with ranibizumab vs. photodynamic therapy in individuals with polypoidal choroidal vasculopathy. Br J Ophthalmol. August 4, 2018. [Epub ahead of print].