Advertisement

Japanese Journal of Ophthalmology

, Volume 55, Issue 4, pp 370–377 | Cite as

Bevacizumab for serous changes originating from a persistent branching vascular network following photodynamic therapy for polypoidal choroidal vasculopathy

Clinical Investigation

Abstract

Purpose

To report the efficacy of intravitreal bevacizumab for either recurrent or persistent serous changes originating from a persistent branching vascular network or secondary choroidal neovascularization after photodynamic therapy for polypoidal choroidal vasculopathy, despite regression of polypoidal lesions.

Methods

Twenty eyes of 20 patients with at least 12 months of regular follow-up were retrospectively reviewed. Intravitreal bevacizumab was administered on an as-needed basis, guided by optical coherence tomography (OCT), after the first injection.

Results

Seventeen (85%) of 20 eyes showed resolution of macular fluid after a mean of 1.9 (range 1–3) consecutive injections; however, 15 (88%) of them had relapsing episodes of fluid collection. The mean number of injections needed was 4.2 (range 1–6) over a period of 12 months. At 12 months, 10 eyes (50%) had no fluid accumulation on OCT, while 10 eyes (50%) had some residual fluid. The mean central foveal thickness improved significantly from 280 ± 37 to 226 ± 62 μm (P = 0.002). Visual acuity was maintained or improved in 16 eyes (80%).

Conclusions

Intravitreal bevacizumab appears to be effective in resolving intraretinal and subretinal fluid originating from these lesions. However, the favorable effect was maintained for only a limited period of time and required repeated injections.

Keywords

Bevacizumab Branching vascular network Photodynamic therapy Polypoidal choroidal vasculopathy 

Notes

Acknowledgments

The study was approved by the institutional review board of the Catholic Medical Center.

References

  1. 1.
    Spaide RF, Donsoff I, Lam DL, Yannuzzi LA, Jampol LM, Slakter J, et al. Treatment of polypoidal choroidal vasculopathy with photodynamic therapy. Retina. 2002;22:529–35.CrossRefPubMedGoogle Scholar
  2. 2.
    Chan WM, Lam DS, Lai TY, Liu DT, Li KK, Yao Y, et al. Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy: one-year results of a prospective case series. Ophthalmology. 2004;111:1576–84.CrossRefPubMedGoogle Scholar
  3. 3.
    Silva RM, Figueira J, Cachulo ML, Duarte L, Faria de Abreu JR, Cunha-Vaz JG. Polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin. Graefes Arch Clin Exp Ophthalmol. 2005;243:973–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Eandi CM, Ober MD, Freund KB, Slakter JS, Yannuzzi LA. Selective photodynamic therapy for neovascular age-related macular degeneration with polypoidal choroidal neovascularization. Retina. 2007;27:825–31.CrossRefPubMedGoogle Scholar
  5. 5.
    Otani A, Sasahara M, Yodoi Y, Aikawa H, Tamura H, Tsujikawa A, et al. Indocyanine green angiography: guided photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2007;144:7–14.CrossRefPubMedGoogle Scholar
  6. 6.
    Gomi F, Ohji M, Sayanagi K, Sawa M, Sakaguchi H, Oshima Y, et al. One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients. Ophthalmology. 2008;115:141–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Sayanagi K, Gomi F, Sawa M, Ohji M, Tano Y. Long-term follow-up of polypoidal choroidal vasculopathy after photodynamic therapy with verteporfin. Graefes Arch Clin Exp Ophthalmol. 2007;245:1569–71.CrossRefPubMedGoogle Scholar
  8. 8.
    Akaza E, Mori R, Yuzawa M. Long-term results of photodynamic therapy of polypoidal choroidal vasculopathy. Retina. 2008;28:717–22.CrossRefPubMedGoogle Scholar
  9. 9.
    Lee WK, Lee PY, Lee SK. Photodynamic therapy for polypoidal choroidal vasculopathy: vaso-occlusive effect on the branching vascular network and origin of recurrence. Jpn J Ophthalmol. 2008;52:108–15.CrossRefPubMedGoogle Scholar
  10. 10.
    Wakabayashi T, Gomi F, Sawa M, Tsujikawa M, Tano Y. Marked vascular changes of polypoidal choroidal vasculopathy after photodynamic therapy. Br J Ophthalmol. 2008;92:936–40.CrossRefPubMedGoogle Scholar
  11. 11.
    Gomi F, Sawa M, Sakaguchi H, Tsujikawa M, Oshima Y, Kamei M, et al. Efficacy of intravitreal bevacizumab for polypoidal choroidal vasculopathy. Br J Ophthalmol. 2008;92:70–3.CrossRefPubMedGoogle Scholar
  12. 12.
    Lai TY, Chan WM, Liu DT, Luk FO, Lam DS. Intravitreal bevacizumab (Avastin) with or without photodynamic therapy for the treatment of polypoidal choroidal vasculopathy. Br J Ophthalmol. 2008;92:661–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Ojima Y, Hangai M, Sakamoto A, Tsujikawa A, Otani A, Tamura H, et al. Improved visualization of polypoidal choroidal vasculopathy lesions using spectral-domain optical coherence tomography. Retina. 2009;29:52–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Costa RA, Navajas EV, Farah ME, Calucci D, Cardillo JA, Scott IU. Polypoidal choroidal vasculopathy: angiographic characterization of the network vascular elements and a new treatment paradigm. Prog Retin Eye Res. 2005;24:560–86.CrossRefPubMedGoogle Scholar
  15. 15.
    Goff MJ, Johnson RN, McDonald HR, Ai E, Jumper JM, Fu A. Intravitreal bevacizumab for previously treated choroidal neovascularization from age-related macular degeneration. Retina. 2007;27:432–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Arias L, Caminal JM, Casas L, Masuet C, Badia MB, Rubio M, et al. A study comparing two protocols of treatment with intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration. Br J Ophthalmol. 2008;92:1636–41.CrossRefPubMedGoogle Scholar
  17. 17.
    Bashshur ZF, Haddad ZA, Schakal A, Jaafar RF, Saab M, Noureddin BN. Intravitreal bevacizumab for treatment of neovascular age-related macular degeneration: a one-year prospective study. Am J Ophthalmol. 2008;145:249–56.CrossRefPubMedGoogle Scholar
  18. 18.
    Sacu S, Michels S, Prager F, Weigert G, Dunavoelgyi R, Geitzenauer W, et al. Randomised clinical trial of intravitreal Avastin vs photodynamic therapy and intravitreal triamcinolone: long-term results. Eye. 2009;23:2223–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Costagliola C, Romano M, Corte MD, Perrotta R, Menzione M, Rinaldi M, et al. Intravitreal bevacizumab for treatment-naive patients with subfoveal occult choroidal neovascularization secondary to age-related macular degeneration: a 12-month follow-up study. Retina. 2009;29:1227–34.CrossRefPubMedGoogle Scholar
  20. 20.
    Carneiro AM, Falcão MS, Brandão EM, Falcão-Reis FM. Intravitreal bevacizumab for neovascular age-related macular degeneration with or without prior treatment with photodynamic therapy: one-year results. Retina. 2010;30:85–92.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2011

Authors and Affiliations

  1. 1.Department of Ophthalmology, Seoul St. Mary’s HospitalThe Catholic University of KoreaSeoulKorea

Personalised recommendations