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Background/aim: We previously reported that ranibizumab performed better on visual prognosis than photodynamic therapy (PDT) in a Ranibizumab ( L ucentis) A nd P hotodynamic T herapy O n P olypoidal 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 mm 2 , 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., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim: To evaluate the association between the foveal external limiting membrane (ELM) status and visual acuity (VA) in diabetic macular oedema (DMO)., Methods: We retrospectively reviewed the spectral domain optical coherence tomography images of 127 eyes from 127 patients with DMO and evaluated the correlation between the logarithm of the minimal angle of resolution (logMAR) VA and the statuses of the foveal ELM, inner segment/outer segment (IS/OS) and cone outer segment tips (COST); foveal macular thickness (FMT); and presence or absence of hard exudates (HE), serous retinal detachment (SRD) and vitreous adhesion. The integrity of the ELM, IS/OS, and COST was classified into three categories (absent, disrupted and complete)., Results: There was a strong correlation between VA and the statuses of the ELM (r=0.699, p<0.001), IS/OS (r=0.716, p<0.001) and COST (r=0.471, p<0.001). There was no correlation between FMT and logMAR VA (r=-0.036, p=0.687). However, when we analysed the correlation between FMT and VA by dividing patients into those with FMT ≤250 μm and those with FMT >250 μm, there was a positive correlation between FMT and VA in eyes with FMT ≤250 μm (r=-0.601, p<0.0001) and a negative correlation in eyes with FMT>250 μm (r=0.290, p<0.01). Other factors HE, SRD and vitreous adhesion did not correlate with VA., Conclusions: In DMO, the ELM status may be as closely related to VA as the IS/OS status.