Abstract
Purpose
To investigate the characteristics of eyes with polypoidal choroidal vasculopathy (PCV) which develop secondary classic choroidal neovascularization (CNV) after photodynamic therapy (PDT).
Methods
We retrospectively reviewed the records of 64 eyes of 64 PCV patients (43 men, 21 women; mean age ± standard deviation, 72.7 ± 8.6 years), who were followed-up for at least 1 year after the initial PDT. There was no evidence of classic CNV in any of the subject eyes on fluorescein angiography (FA) at the first PDT. Eyes which developed of secondary classic CNV after PDT were classified as the CNV group and the other eyes as the No-CNV group.
Results
Secondary classic CNV developed after PDT in 10 (15.6%) of the 64 eyes. Six patients developed CNV within 1 year after the first PDT. Multivariate logistic regression analysis for the baseline factors related to CNV development, including age, gender, greatest linear dimension, and the lesion components, revealed that in the CNV group the age was significantly younger (p = 0.037) and the incidence of retinal edema was significantly greater (p = 0.041) than in the No-CNV group.
Conclusions
Secondary classic CNV tends to develop after PDT in PCV eyes in younger patients with retinal edema.
Similar content being viewed by others
References
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.
Ogino T, Takeda M, Imaizumi H, Okushiba U. Photodynamic therapy for age-related macular degeneration in Japanese patients: results after one year. Jpn J Ophthalmol. 2007;51:210–5.
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.
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.
Kurashige Y, Otani A, Sasahara M, Yodoi Y, Tamura H, Tsujikawa A, et al. Two-year results of photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2008;146:513–9.
Yamashiro K, Tsujikawa A, Nishida A, Mandai M, Kurimoto Y. Recurrence of polypoidal choroidal vasculopathy after photodynamic therapy. Jpn J Ophthalmol. 2008;52:457–62.
Brown DM, Michels M, Kaiser PK, Heier JS, Sy JP, Ianchulev T. Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: two-year results of the ANCHOR study. Ophthalmology. 2009;116:57–65.
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.
Tamura H, Tsujikawa A, Otani A, Gotoh N, Sasahara M, Kameda T, et al. Polypoidal choroidal vasculopathy appearing as classic choroidal neovascularisation on fluorescein angiography. Br J Ophthalmol. 2007;91:1152–9.
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.
Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials—TAP report. Arch Ophthalmol. 1999;117:1329–45.
Akaza E, Mori R, Yuzawa M. Long-term results of photodynamic therapy of polypoidal choroidal vasculopathy. Retina. 2008;28:717–22.
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.
Verteporfin in photodynamic therapy study group. Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization—verteporfin in photodynamic therapy report 2. Am J Ophthalmol. 2001;131:541–60.
Spaide RF, Yannuzzi LA, Slakter JS, Sorenson J, Orlach DA. Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy. Retina. 1995;15:100–10.
Yannuzzi LA, Wong DW, Sforzolini BS, Goldbaum M, Tang KC, Spaide RF, et al. Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration. Arch Ophthalmol. 1999;117:1503–10.
Uyama M, Wada M, Nagai Y, Matsubara T, Matsunaga H, Fukushima I, et al. Polypoidal choroidal vasculopathy: natural history. Am J Ophthalmol. 2002;133:639–48.
Tatar O, Kaiserling E, Adam A, Gelisken F, Shinoda K, Völker M, et al. Consequences of verteporfin photodynamic therapy on choroidal neovascular membranes. Arch Ophthalmol. 2006;124:815–23.
Tatar O, Adam A, Shinoda K, Stalmans P, Eckardt C, Lüke M, et al. Expression of VEGF and PEDF in choroidal neovascular membranes following verteporfin photodynamic therapy. Am J Ophthalmol. 2006;142:95–104.
Busch T. Approaches toward combining photodynamic therapy with pharmaceuticals that alter vascular microenvironment. Retina. 2009;29:S36–8.
Saito M, Iida T, Nagayama D. Photodynamic therapy with verteporfin for age-related macular degeneration or polypoidal choroidal vasculopathy: comparison of the presence of serous retinal pigment epithelial detachment. Br J Ophthalmol. 2008;92:1642–7.
Mori R, Yuzawa M, Lee Z, Haruyama M, Akaza E. Factors influencing visual outcome of polypoidal choroidal vasculopathy one year after photodynamic therapy. Graefes Arch Clin Exp Ophthalmol. 2010;248:1233–9.
Antoszyk AN, Tuomi L, Chung CY, Singh A. Ranibizumab combined with verteporfin photodynamic therapy in neovascular age-related macular degeneration (FOCUS): year 2 results. Am J Ophthalmol. 2008;145:862–74.
Sato T, Kishi S, Matsumoto H, Mukai R. Combined photodynamic therapy with verteporfin and intravitreal bevacizumab for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2010;149:947–54.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Imasawa, M., Sakurada, Y. & Iijima, H. Classic choroidal neovascularization developing after photodynamic therapy in eyes with polypoidal choroidal vasculopathy. Jpn J Ophthalmol 55, 241–247 (2011). https://doi.org/10.1007/s10384-011-0006-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10384-011-0006-6