Five-year visual outcomes after anti-VEGF therapy with or without photodynamic therapy for polypoidal choroidal vasculopathy

Miyata, Manabu; Ooto, Sotaro; Yamashiro, Kenji; Tamura, Hiroshi; Hata, Masaharu; Ueda-Arakawa, Naoko; Yoshikawa, Munemitsu; Numa, Shogo; Tsujikawa, Akitaka

doi:10.1136/bjophthalmol-2018-311963

Cited by 22 publications

(20 citation statements)

References 24 publications

(25 reference statements)

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“…Several studies reported long-term results of the combination therapy involving PDT and anti-VEGF agents for PCV. [13,16,17] Miyata et al reported 5-year results after combination therapy involving PDT and intravitreal injection of ranibizumab for 20 eyes with PCV. In their report, BCVA significantly improved at 1 year, but thereafter BCVA declined and returned to baseline value at 5 year.…”

Section: Discussionmentioning

confidence: 99%

“…[7] Since the follow-up period was short in most studies reporting the combination therapy, [8][9][10][11][12] there has been few reports investigating 5-year outcome of combination therapy of PDT and intravitreal injection of anti-VEGF agent for PCV. [13] In the present study, we report 5-year visual and anatomical outcomes after combination therapy of PDT and intravitreal injection of ranibizumab or aflibercept for PCV and the predictive factors for visual outcomes at 5 years and time to recurrence during the follow-up.…”

Section: Introductionmentioning

confidence: 93%

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Five-year outcomes of photodynamic therapy combined with intravitreal injection of ranibizumab or aflibercept for polypoidal choroidal vasculopathy

et al. 2020

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We report 5-year visual and anatomical outcomes after combination therapy of photodynamic therapy (PDT) and intravitreal injection of ranibizumab or aflibercept for polypoidal choroidal vasculopathy (PCV) and predictive factors for visual outcomes at 5-year and time to recurrence. Medical charts were retrospectively reviewed for 43 consecutive eyes with PCV treated with combination therapy of PDT and intravitreal injection of ranibizumab(n = 13) or aflibercept(n = 30) and completed 5-year follow-up. The variants of ARMS2 A69S and CFH I62V were genotyped using TaqMan assay. Best corrected visual acuity (BCVA) significantly improved at 5-year (P = 0.01) with 20% reduction of subfoveal choroidal thickness irrespective of presence or absence of recurrence. Visual improvement was associated with baseline shorter greatest linear dimension (GLD) (P = 1.0×10 −4). Mean time to recurrence was 28.6±23.1 months (95% CI: 21.5-35.7, Median:18.0) and time to recurrence was associated with G allele (protective allele) of ARMS2 A69S and GLD (P = 4.0×10 −4 and 1.0×10 −2 , respectively). Multiple regression analysis revealed that time to recurrence extended by 15.5 months when the G allele of ARMS2 A69S increased by one allele (TT: 15.7±17.0, TG: 30.8±23.5, GG: 41.1±22.6 months). The combination therapy resulted in a favorable visual outcome for PCV during 5-year follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

Five-year outcomes of photodynamic therapy combined with intravitreal injection of ranibizumab or aflibercept for polypoidal choroidal vasculopathy

et al. 2020

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“…Miyata et al reported that BCVA improved relative to the baseline only in the first year and not after 3 to 5 years. Moreover, CRT after 5 years was reported to be similar to the baseline CRT 30 . Wataru et al detected a similar deterioration of BCVA improvement after 3 years.…”

Section: Discussionmentioning

confidence: 74%

“…However, several reports have indicated that repeated PDT might damage the retinal pigment epithelium and choriocapillaris layer 32 , 33 . In addition, Miyata et al reported a marginally significant increase ( P = 0.06) in rate of macular atrophy in the combination therapy group, and they considered repeated PDT to be related to macular atrophy in the long term 30 . Nonetheless, there is still no sufficient evidence regarding the long-term consequences of PDT.…”

Section: Discussionmentioning

confidence: 99%

Systematic review with network meta-analysis of antivascular endothelial growth factor use in managing polypoidal choroidal vasculopathy

Chi

Kang

Huang

2021

Sci Rep

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Polypoidal choroidal vasculopathy (PCV) is a vision-threatening disease common in Asian populations. However, the optimal treatment for PCV remains under debate. We searched the databases with optimal searching strategy. The study included randomized clinical trials and prospective studies that recruited patients with active PCV who had received interventions, including PDT, anti-VEGF, or a combination of PDT and anti-VEGF. The Grading of Recommendations Assessment, Development, and Evaluation methodology was used for rating the quality of evidence. Our study included 11 studies involving 1277 patients. The network meta-analysis of RCTs revealed the anti-VEGF group, early combination group, and late combination group had significant BCVA changes compared with the PDT group. Early combination therapy led to a significant decrease in CRT compared with PDT, anti-VEGF, and late combination therapy. Additionally, the early combination group had a significantly higher complete polyp regression rate than the anti-VEGF group. No significant differences were detected in the analysis of the number of anti-VEGF injections and safety profile. This network meta-analysis revealed that early combination therapy exhibited better efficacy related to anatomical outcomes than other therapies. Nonetheless, no significant differences related to BCVA change could be detected between anti-VEGF and late combination therapy.

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“…Recently, Miyata et al reported the five-year results of therapy combining anti-VEGF drugs with PDT for PCV. The combination therapy with PDT was more likely to result in macular atrophy than that with anti-VEGF alone [ 20 ]. Son et al compared half-dose versus full-dose PDT for CSC and found no difference in macular atrophy at three years between the two groups [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Two-Thirds Dose Photodynamic Therapy for Pachychoroid Neovasculopathy

Takada

Mori

Wakatsuki

et al. 2021

JCM

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Pachychoroid neovasculopathy (PNV) is treated with antivascular endothelial growth factor (VEGF) injection and photodynamic therapy (PDT), but no curative treatment has yet been established. We aimed to clarify the treatment results of a reduced dose of PDT for PNV. The subjects were 27 eyes of 27 patients (male:female = 20:7, mean age 58.9 years). PDT, at 2/3 of the conventional dose (2/3PDT), was administered once. The patients were then observed for one year. Eyes with polypoidal choroidal vasculopathy (PCV) were excluded. We investigated the associations among the central retinal thickness, choroidal thickness, and visual acuity changes before treatment and one, three, six and 12 months after PDT. When serous retinal detachment was increased or unchanged or new hemorrhages were observed, as compared with pretreatment findings, intravitreal injection of an anti-VEGF agent was performed. Visual acuity was significantly improved, as compared to before treatment, at three, six, and 12 months after 2/3PDT. Foveal retinal thickness was significantly decreased after versus before treatment in the 2/3PDT group (p < 0.001). Foveal choroidal thickness was also significantly reduced in the 2/3PDT group (p = 0.001). Additional intravitreal anti-VEGF agent injections were administered to three patients (11%), while 24 (89%) required no additional treatment during the one-year follow-up period. For PNV without polyps, 2/3PDT appears to be effective.

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Five-year visual outcomes after anti-VEGF therapy with or without photodynamic therapy for polypoidal choroidal vasculopathy

Cited by 22 publications

References 24 publications

Five-year outcomes of photodynamic therapy combined with intravitreal injection of ranibizumab or aflibercept for polypoidal choroidal vasculopathy

Five-year outcomes of photodynamic therapy combined with intravitreal injection of ranibizumab or aflibercept for polypoidal choroidal vasculopathy

Systematic review with network meta-analysis of antivascular endothelial growth factor use in managing polypoidal choroidal vasculopathy

Two-Thirds Dose Photodynamic Therapy for Pachychoroid Neovasculopathy

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