Combined photodynamic therapy with verteporfin and intravitreal bevacizumab for polypoidal choroidal vasculopathy

Abstract

Purpose: To evaluate the efficacy of photodynamic therapy with verteporfin with intravitreal bevacizumab for polypoidal choroidal vasculopathy.

Design: Retrospective case study.

Methods: This study included 29 treatment-naïve patients with polypoidal choroidal vasculopathy followed up for 12 months after the first combined therapy. Patients received 1.25 mg intravitreal bevacizumab 1 week before photodynamic therapy with verteporfin. The main outcomes measures were visual acuity and the number of required retreatments.

Results: The mean best-corrected visual acuity (BCVA) level was 0.25 at baseline and 0.31, 0.39, 0.44, 0.44, and 0.45 at 1, 3, 6, 9, and 12 months after treatment, respectively. A significant (P< .01) improvement in the mean BCVA was observed at 3, 6, 9, and 12 months after combined therapy. At 12 months, the mean improvement in BCVA from baseline was 2.69 lines; the BCVA improved in 15 eyes (51.7%) by 3 lines or more, was stable in 13 eyes (44.8%), and decreased in 1 eye (3%) because of a massive subretinal hemorrhage 7 months after the first treatment. Eighteen eyes (62%) required 1 combined treatment during follow-up. Polypoidal lesions recurred in 6 eyes (21%). An abnormal branching vascular network persisted in all eyes. The mean number of treatments with combined therapy averaged 1.59. No complications, including endophthalmitis, uveitis, or ocular hypertension, developed.

Conclusions: Combined treatment consisting of photodynamic therapy with verteporfin and intravitreal bevacizumab for polypoidal choroidal vasculopathy seemed to be effective for improving visual acuity and reducing retreatment rates and complications. Further study is needed to determine the long-term clinical results.