Two-year results of photodynamic therapy combined with intravitreal anti-vascular endothelial growth factor for polypoidal choroidal vasculopathy

Abstract

Background/aims: To evaluate the 2-year efficacy of photodynamic therapy (PDT) combined with intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) in patients with polypoidal choroidal vasculopathy (PCV).

Methods: Twenty-two eyes of 22 patients with PCV followed up for ≥24 months after PDT and anti-VEGF combination therapy were retrospectively reviewed. The patients received intravitreal anti-VEGF (1.25 mg bevacizumab or 0.5 mg ranibizumab) within 7 days after PDT. Eyes were retreated with PDT and anti-VEGF injection, or with only anti-VEGF injection, when indicated. Main outcome measures were best-corrected visual acuity (BCVA) and central foveal thickness (CFT).

Results: The mean baseline BCVA (0.43±0.33 logarithm of the minimum angle of resolution, logMAR) was 0.28±0.24 at 12 months (p<0.05 vs. baseline) and 0.39±0.28 at 24 months (not significant). At 24 months, BCVA improved by ≥0.3 logMAR in 27.3% of the eyes, did not significantly decrease in 59.1%, and decreased by ≥0.3 logMAR in 13.6%. The mean CFT was 269.4±134.5 μm at baseline and significantly decreased to 139.6±45.8 μm (12 months) and 199.6±72.9 μm (24 months). PDT was administered 1.45±0.86 times and anti-VEGF injected 4.45±1.36 times over the 24-month period.

Conclusion: Combined PDT and anti-VEGF injection were effective for 2 years in PCV patients. Visual acuity significantly improved during year 1, but the benefit diminished in year 2. Further investigations are required to determine how to prolong the therapeutic effect of combination therapy for PCV.