Two-Year Results of Photodynamic Therapy Combined with Intravitreal Anti-Vascular Endothelial Growth Factor for Polypoidal Choroidal Vasculopathy; A Real Life Experience

INTRODUCTION: The aim of this study was to evaluate the 2-year outcomes of intravitreal ranibizumab (IVR) therapy in combination with photodynamic therapy (PDT) in patients with polypoidal choroidal vasculopathy (PCV).
METHODS: Patients with PCV who presented at the clinic between January 2013 and January 2014 were reviewed retrospectively. Twenty-three eyes of 23 patients were included in this study. Indocyanine green angiography was performed to confirm the diagnosis of PCV in all patients. IVR was administered within a week following PDT, then followed by additional IVR as needed. Best corrected visual acuity (BCVA) measurement, biomicroscopic examination, and central macular thickness (CMT) measurement via optical coherence tomography at baseline and at 3, 6, 12, 18, and 24 months were performed. The mean change in BCVA and CMT at follow-up was compared with the baseline.
RESULTS: A total of 23 eyes of 23 patients were included in this study. The mean age of the patients was 65.8±7.4 years (range: 55-82 years). The mean BCVA (logMAR, or logarithm of the minimum angle of resolution) was 0.68±0.45 at baseline, 0.67±0.45 at 3 months (p=0.24), 0.66±0.45 at 6 months (p=0.43), 0.69±0.43 at 12 months (p=0.95), 0.69±0.42 at 18 months (p=0.54), and 0.70±0.42 at 24 months (p=0.56). The mean CMT was 334.5±99.4 μm at baseline, 313.4±96.1 μm at 3 months (p=0.27), 319.1±106.5 μm at 6 months (p=0.44), 303.52±128.33 μm (p=0.17) at 12 months, 246.6±80.8μm at 18 months (p=0.0001), and 226.9±71.7 μm at 24 months (p=0.0001).
DISCUSSION AND CONCLUSION: Verteporfin PDT administered in combination with IVR was an effective treatment for preserving VA in PCV for a 2-year period. Our results need to be confirmed in further studies in a real-life setting.