Skip to main content

Advertisement

Log in

Comparison of initial treatment between 3-monthly intravitreal aflibercept monotherapy and combined photodynamic therapy with single intravitreal aflibercept for polypoidal choroidal vasculopathy

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To compare the efficacy of two different initial treatment modalities on visual outcome, need for retreatment, and angiographic improvement during 12-month follow-up for polypoidal choroidal vasculopathy (PCV).

Methods

A retrospective medical chart review was performed for 66 eyes from 66 patients with treatment-naïve PCV. Visual and angiographic improvements and the incidence of retreatment for recurrence or residual pathology were compared between two groups that underwent either intravitreal aflibercept injection (IAI) monotherapy (n = 33) or combined photodynamic therapy (PDT) with IAI (n = 33).

Results

Best-corrected visual acuity improved significantly (P < 0.001) in both groups at each of the 3-monthly visits during the 12-month follow-up period, with no difference between groups at 12 months (P = 0.56). The relative risk of the need for retreatment was significantly lower in the combined PDT and IAI group than in the IAI monotherapy group (P = 0.007). Angiographic regression of polypoidal vascular lesions occurred more frequently in the combined PDT group than in the IAI monotherapy group at 3 (87.5 % vs 56.7 %) and 12 months (68.8 % vs 60.0 %) (p = 0.0065 and p = 0.47 respectively).

Conclusions

The combination of PDT with IAI as the initial treatment for PCV may be superior to IAI monotherapy in terms of disease-stabilizing efficacy, but with equivalent visual gain at 12 months.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Spaide RF, Yannuzzi LA, Slakter JS, Sorenson J, Orlach DA (1995) Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy. Retina 15:100–110

    Article  CAS  PubMed  Google Scholar 

  2. Yannuzzi LA, Wong DW, Sforzolini BS, Goldbaum M, Tang KC, Spaide RF, Freund KB, Slakter JS, Guyer DR, Sorenson JA, Fisher Y, Maberley D, Orlock DA (1999) Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration. Arch Ophthal 117:1503–1510

    Article  CAS  PubMed  Google Scholar 

  3. Bessho H, Honda S, Imai H, Negi A (2011) Natural course and funduscopic findings of polypoidal choroidal vasculopathy in a Japanese population over 1 year of follow-up. Retina 31:1598–1602. doi:10.1097/IAE.0b013e31820d3f28

    Article  PubMed  Google Scholar 

  4. Spaide RF, Donsoff I, Lam DL, Yannuzzi LA, Jampol LM, Slakter J, Sorenson J, Freund KB (2002) Treatment of polypoidal choroidal vasculopathy with photodynamic therapy. Retina 22:529–535

    Article  PubMed  Google Scholar 

  5. Chan WM, Lam DS, Lai TY, Liu DT, Li KK, Yao Y, Wong TH (2004) Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy: one-year results of a prospective case series. Ophthalmology 111:1576–1584. doi:10.1016/j.ophtha.2003.12.056

    Article  PubMed  Google Scholar 

  6. Silva RM, Figueira J, Cachulo ML, Duarte L, de Abreu JR F, Cunha-Vaz JG (2005) Polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin. Graefes Arch Clin Exp Ophthalmol 243:973–979. doi:10.1007/s00417-005-1139-4

    Article  CAS  PubMed  Google Scholar 

  7. Otani A, Sasahara M, Yodoi Y, Aikawa H, Tamura H, Tsujikawa A, Yoshimura N (2007) Indocyanine green angiography: guided photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol 144:7–14. doi:10.1016/j.ajo.2007.03.014

    Article  CAS  PubMed  Google Scholar 

  8. Saito M, Iida T, Kano M, Itagaki K (2013) Two-year results of combined intravitreal ranibizumab and photodynamic therapy for polypoidal choroidal vasculopathy. Graefes Archiv Clin Exp Ophthalmol 251:2099–2110. doi:10.1007/s00417-013-2323-6

    Article  CAS  Google Scholar 

  9. Sakurada Y, Iijima H (2013) Two-year results of photodynamic therapy with or without intravitreal ranibizumab for polypoidal choroidal vasculopathy. J Ocul Pharmacol Ther 29:832–836. doi:10.1089/jop.2013.0044

    Article  CAS  PubMed  Google Scholar 

  10. Kang HM, Koh HJ, Lee CS, Lee SC (2014) Combined photodynamic therapy with intravitreal bevacizumab injections for polypoidal choroidal vasculopathy: long-term visual outcome. Am J Ophthalmol 157(598–606), e591. doi:10.1016/j.ajo.2013.11.015

    Google Scholar 

  11. Holash J, Davis S, Papadopoulos N, Croll SD, Ho L, Russell M, Boland P, Leidich R, Hylton D, Burova E, Ioffe E, Huang T, Radziejewski C, Bailey K, Fandl JP, Daly T, Wiegand SJ, Yancopoulos GD, Rudge JS (2002) VEGF-Trap: a VEGF blocker with potent antitumor effects. Proc Natl Acad Sci U S A 99:11393–11398. doi:10.1073/pnas.172398299

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Hara C, Sawa M, Sayanagi K, Nishida K (2016) One-year results of intravitreal aflibercept for polypoidal choroidal vasculopathy. Retina 36:37–45. doi:10.1097/IAE.0000000000000767

    Article  CAS  PubMed  Google Scholar 

  13. Yamamoto A, Okada AA, Kano M, Koizumi H, Saito M, Maruko I, Sekiryu T, Iida T (2015) One-year results of intravitreal aflibercept for polypoidal choroidal vasculopathy. Ophthalmology 122:1866–1872. doi:10.1016/j.ophtha.2015.05.024

    Article  PubMed  Google Scholar 

  14. Sato T, Kishi S, Matsumoto H, Mukai R (2010) Combined photodynamic therapy with verteporfin and intravitreal bevacizumab for polypoidal choroidal vasculopathy. Am J Ophthalmol 149 (6):947.e1–954.e1. doi:10.1016/j.ajo.2009.12.038

    Article  Google Scholar 

  15. Bashshur ZF, Schakal AR, El-Mollayess GM, Arafat S, Jaafar D, Salti HI (2011) Ranibizumab monotherapy versus single-session verteporfin photodynamic therapy combined with as-needed ranibizumab treatment for the management of neovascular age-related macular degeneration. Retina 31:636–644. doi:10.1097/IAE.0b013e3181fe54ab

    Article  CAS  PubMed  Google Scholar 

  16. Maruko I, Iida T, Oyamada H, Sugano Y, Ojima A, Sekiryu T (2013) Choroidal thickness changes after intravitreal ranibizumab and photodynamic therapy in recurrent polypoidal choroidal vasculopathy. Am J Ophthalmol 156:548–556. doi:10.1016/j.ajo.2013.03.041

    Article  CAS  PubMed  Google Scholar 

  17. Koh A, Lee WK, Chen LJ, Chen SJ, Hashad Y, Kim H, Lai TY, Pilz S, Ruamviboonsuk P, Tokaji E, Weisberger A, Lim TH (2012) EVEREST study: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina 32:1453–1464. doi:10.1097/IAE.0b013e31824f91e8

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yoichi Sakurada.

Ethics declarations

Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments orcomparable ethical standards.

Informed consent

For this type of study, formal consent is not required. However, informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kikushima, W., Sakurada, Y., Sugiyama, A. et al. Comparison of initial treatment between 3-monthly intravitreal aflibercept monotherapy and combined photodynamic therapy with single intravitreal aflibercept for polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol 255, 311–316 (2017). https://doi.org/10.1007/s00417-016-3467-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-016-3467-y

Keywords

Navigation