Institutional members access full text with Ovid®

Share this article on:

ADJUSTED RETREATMENT OF POLYPOIDAL CHOROIDAL VASCULOPATHY AFTER COMBINATION THERAPY: Results at 3 Years

Jeon, Sohee MD; Lee, Won Ki MD, PhD; Kim, Kyu Seop MD

doi: 10.1097/IAE.0b013e318276e096
Original Studies

Purpose: The purpose of this study was to evaluate the 3-year outcome of adjusted retreatment with photodynamic therapy (PDT), thermal laser, and intravitreal bevacizumab (IVB) after their initial PDT/IVB combination therapy for polypoidal choroidal vasculopathy.

Methods: Data on 40 treatment-naive eyes of 38 patients with polypoidal choroidal vasculopathy were reviewed, all initially subjected to whole-lesion PDT/IVB. When retreating persistent or recurrent exudation, the aim was to reduce PDT frequency and spot size, avoiding whole-lesion PDT when feasible. Distinct polyps were thus selectively targeted using PDT and/or laser, routinely combined with IVB. If polyps were absent or questionable, IVB monotherapy was given.

Results: At Year 3, the mean logarithm of minimal angle of resolution best-corrected visual acuity improved from 0.67 (Snellen equivalent of 20/93) to 0.55 (Snellen equivalent of 20/70), but the improvement was not statistically significant (P = 0.076). Best-corrected visual acuity remained stable or improved in 33 eyes (82.5%). The mean number of combination treatments and total IVB courses were 1.66 (range, 1–4) and 5.92 (range, 1–18), respectively. Five eyes (12.5%) required focal laser treatment for extrafoveal polypoidal lesions during follow-up.

Conclusion: Compared with reported 3-year outcomes of PDT as monotherapy for polypoidal choroidal vasculopathy, this approach proved favorable in improving or stabilizing visual acuity and reducing cumulative PDT exposure.

An adjusted retreatment using photodynamic therapy, laser, and bevacizumab after initial combination therapy showed favorable results concerning stable vision, and reducing the total number of photodynamic therapy when compared with previously published data that reported 3-year results of photodynamic therapy monotherapy for polypoidal choroidal vasculopathy.

Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Reprint requests: Won K. Lee, MD, PhD, Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea; e-mail: wklee@catholic.ac.kr

The authors have no proprietary or financial interest in any aspect of this study.

© 2013 by Ophthalmic Communications Society, Inc.