Long-term results of photodynamic therapy or ranibizumab for polypoidal choroidal vasculopathy in LAPTOP study

Br J Ophthalmol. 2019 Jun;103(6):844-848. doi: 10.1136/bjophthalmol-2018-312419. Epub 2018 Aug 4.

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.

Keywords: Degeneration; Macula.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Angiogenesis Inhibitors / administration & dosage
  • Choroid / blood supply*
  • Choroid Diseases / diagnosis
  • Choroid Diseases / drug therapy*
  • Follow-Up Studies
  • Humans
  • Injections, Intravenous
  • Intravitreal Injections
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use
  • Polyps / diagnosis
  • Polyps / drug therapy*
  • Ranibizumab / administration & dosage*
  • Retrospective Studies
  • Time Factors
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Verteporfin / administration & dosage*
  • Visual Acuity*

Substances

  • Angiogenesis Inhibitors
  • Photosensitizing Agents
  • Vascular Endothelial Growth Factor A
  • Verteporfin
  • Ranibizumab