Short-Term Outcomes of Switching to Ranibizumab in Polypoidal Choroidal Vasculopathy Resistant to Aflibercept Therapy

Background: To evaluate the short-term outcomes of switching to ranibizumab in aflibercept-resistant polypoidal choroidal vasculopathy (PCV). Methods: This retrospective study included 18 eyes diagnosed with aflibercept-resistant PCV. All patients were treated with two to four consecutive ranibizumab injections at 4-5-week intervals. The best-corrected visual acuity (BCVA), and central retinal thickness (CRT) values before and after switching to ranibizumab were compared. The proportion of eyes showing >= 100 mu m decrease in retinal thickness and/or complete resolution of fluid after switching was identified. Results: The mean number of aflibercept injections before switching was 5.7 +/- 3.3. After switching, a mean of 2.8 +/- 0.6 consecutive ranibizumab injections was performed. The mean logarithm of minimal angle of resolution (logMAR) BCVA was 0.41 +/- 0.26 (Snellen equivalents = 20/51) before switching, and 0.40 +/- 0.30 (20/50) after switching (p = 0.574). The mean CRT was 422.2 +/- 152.4 mu m before switching, and 400.7 +/- 182.0 mu m after switching (p = 0.236). A decrease in CRT of >= 100 mu m, and/or complete resolution of fluid was noted in three eyes (16.7%). Conclusions: Switching to ranibizumab in aflibercept-resistant polypoidal choroidal vasculopathy was not effective in most patients, suggesting the need for further investigation to seek more effective treatment options for this condition.