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COMPARISON OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHIC CHANGES AFTER ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY ALONE OR IN COMBINATION WITH PHOTODYNAMIC THERAPY IN POLYPOIDAL CHOROIDAL VASCULOPATHY

Teo, Kelvin Yi, Chong, MBBS, MMed (Ophth)*,†; Yanagi, Yasuo, MMed (Ophth), FRCS(Ed), FAMS*,†; Lee, Shu, Yen, MMed (Ophth), FRCS(Ed), FAMS*,†,‡; Yeo, Ian Yew, San, MMed (Ophth), FRCS(Ed), FRCS(G), FAMS*,†,‡,§; Tan, Gavin Siew, Wei, MMed (Ophth), FRCS(Ed), FAMS*,†,‡; Mathur, Ranjana, MMed (Ophth), FRCS(Ed)*,†,‡; Chan, Choi, Mun, MMed (Ophth), FRCS(Ed), FAMS*,†,‡; Wong, Tien, Yin, MMed (Ophth), MPH, FRCS(Ed), FRANZCO, FAFPHM, PhD*,†,‡,§; Cheung, Chui Ming, Gemmy, MBBS, FRCOphth*,†,‡,§

doi: 10.1097/IAE.0000000000001776
Original Study: PDF Only

Purpose: To compare changes in optical coherence tomography angiography in eyes with polypoidal choroidal vasculopathy after treatment with anti–vascular endothelial growth factor monotherapy or combined with photodynamic therapy.

Methods: This is a longitudinal case-controlled study. The authors performed optical coherence tomography angiography at baseline and Month 3 in patients with treatment-naive polypoidal choroidal vasculopathy undergoing monotherapy (n = 10) or combination therapy (n = 13). We analyzed flow signal within the outer retina and choriocapillaris using automated segmentation. The authors analyzed the presence of pachyvessels using a 10.4-μm segment through Haller layer. The changes in each layer were compared between treatments.

Results: At Month 3, both groups showed similar improvement in best-corrected visual acuity and central retinal thickness. However, flow signal within the polypoidal choroidal vasculopathy complex was decreased in more eyes after combination therapy than after monotherapy (84.6% vs. 40.0%, P = 0.04). Patchy reduction in flow signal within the choriocapillaris layer was noted in 15.4% and 10.0% after combination therapy and monotherapy, respectively (P = 0.61). Significant reduction in pachyvessel caliber was seen only after combination therapy but not after monotherapy (75.0% vs. 0.0%, P = 0.01).

Conclusion: Longitudinal optical coherence tomography angiography demonstrates more significant reduction in lesion flow and pachyvessels in the short term after combination therapy than after monotherapy, although visual and structural OCT showed similar improvement.

This study compares the optical coherence tomography angiography changes in the retina and choroid after anti–vascular endothelial growth factor monotherapy and combination with photodynamic therapy for polypoidal choroidal vasculopathy.

*Singapore National Eye Centre, Retina Department, Singapore;

Singapore Eye Research Institute, Singapore;

Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; and

§Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore.

Reprint requests: Chui Ming Gemmy Cheung, Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751; e-mail: gemmy.cheung.c.m@snec.com.sg

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.