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Five-year results of photodynamic therapy with and without supplementary antivascular endothelial growth factor treatment for polypoidal choroidal vasculopathy

  • Retinal Disorders
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Abstract

Background

To clarify the long-term efficacy of photodynamic therapy (PDT) in patients with symptomatic polypoidal choroidal vasculopathy (PCV).

Methods

We retrospectively reviewed 60 naive eyes of 59 patients (45 men, 14 women; mean age, 73.8 years) treated with full-fluence PDT (PDT group) and followed for at least 60 months. Retreatment was either antivascular endothelial growth factor (VEGF) therapy or intravitreal triamcinolone acetonide if PDT alone was ineffective (supplemental retreatment group).

Results

The mean logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) levels at baseline and 60 months were 0.66 and 0.71, respectively. The mean change at 60 months was a decrease of 0.50 line. In the PDT group (36 eyes), the mean BCVAs at baseline and month 60 were 0.73 and 0.68, respectively (p = 0.60). In the supplemental retreatment group (24 eyes), the mean BCVAs at baseline and month 60 were 0.55 and 0.74, respectively (p = 0.076). The percentage of eyes with decreased BCVA at the time of the additional anti-VEGF treatment was significantly (p = 0.031) higher than at month 60. The risk factors identified by multiple regression analysis with a significant decrease in BCVA at month 60 were a large greatest linear dimension (GLD), classic choroidal neovascularization at baseline, and a hemorrhage over the arcade vessels after PDT.

Conclusions

The efficacy of PDT for PCV depends on the GLD. Twenty-four of the 60 eyes needed additional treatment other than only PDT during 60 months of follow-up. Additional anti-VEGF treatment may help maintain the BCVA of patients with exudative or anatomic recurrence.

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Conlict of interest

The authors have no proprietary interest in any aspect of this study and received no government funding.

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Authors and Affiliations

  1. Department of Ophthalmology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Masaaki Saito, Tomohiro Iida, Mariko Kano & Kanako Itagaki

  2. Department of Ophthalmology, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan

    Tomohiro Iida

Authors
  1. Masaaki Saito
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  2. Tomohiro Iida
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  3. Mariko Kano
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  4. Kanako Itagaki
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Correspondence to Masaaki Saito.

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Saito, M., Iida, T., Kano, M. et al. Five-year results of photodynamic therapy with and without supplementary antivascular endothelial growth factor treatment for polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol 252, 227–235 (2014). https://doi.org/10.1007/s00417-013-2433-1

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  • DOI: https://doi.org/10.1007/s00417-013-2433-1

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