J Korean Ophthalmol Soc.  2017 Jun;58(6):646-652. 10.3341/jkos.2017.58.6.646.

Long-term Results of Reduced-fluence Photodynamic Therapy Combined with Intravitreal Anti-Vascular Endothelial Growth Factor for Polypoidal Choroidal Vasculopathy

• Han JY
• Kim SW
• Oh J

• KMID: 2382672
• DOI: http://doi.org/10.3341/jkos.2017.58.6.646

Abstract

PURPOSE
To evaluate the long-term effects of reduced-fluence photodynamic therapy (RF-PDT) combined with intravitreal anti-vascular endothelial growth factor (anti-VEGF) for polypoidal choroidal vasculopathy (PCV).
METHODS
Twenty-two eyes of 21 patients with PCV that were followed up for more than 24 months after RF-PDT and anti-VEGF combination therapy were retrospectively reviewed. The patients received intravitreal anti-VEGF (bevacizumab 1.25 mg, ranibizumab 0.5 mg, or aflibercept 2.0 mg) within 7 days of PDT. Patients were retreated with either RF-PDT and anti-VEGF injection, or with only anti-VEGF injection, as indicated. The main outcome measures were best-corrected visual acuity (BCVA) and central foveal thickness (CFT), which were measured before and after combination therapy.
RESULTS
During follow-up, the mean logMAR BCVA significantly improved from 0.75 at baseline to 0.54 at 12 months and 0.52 at 24 months (p=0.009 and p=0.032, respectively). The mean CFT significantly decreased from 409.8 µm at baseline to 234.1 µm at 12 months and 245.9 µm at 24 months (p<0.001 and p=0.001, respectively). In 20 eyes (90.9%), the BCVA remained stable or improved.
CONCLUSIONS
The efficacy of this combination therapy for 24 months resulted in stabilized vision and anatomical improvement. RF-PDT combined with intravitreal anti-VEGF injection could be an effective treatment modality for patients with PCV.

Keyword

Polypoidal choroidal vasculopathy; Reduced fluence photodynamic therapy; Vascular endothelial growth factor

MeSH Terms

Choroid*
Endothelial Growth Factors*
Follow-Up Studies
Humans
Outcome Assessment (Health Care)
Photochemotherapy*
Ranibizumab
Retrospective Studies
Vascular Endothelial Growth Factor A
Visual Acuity
Endothelial Growth Factors
Ranibizumab
Vascular Endothelial Growth Factor A

Figure

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  Figure 1 The changes in mean logMAR best-corrected visual acuity (BCVA) over time after combination therapy. The mean logMAR BCVA significantly improved at 6, 12 and 24 months after combination therapy. *Paired t-test (p<0.05).

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  Figure 2 The changes in mean central foveal thickness (CFT) on optical coherence tomography over time after combination therapy. The mean CFT significantly decreased at 3, 6, 12 and 24 months after combination therapy. *Paired t-test (p<0.05).

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