One-Year Results of Half- Versus Standard-Dose Photodynamic Therapy Combined With Ranibizumab for Polypoidal Choroidal Vasculopathy

Wong, Ian Yu‐Hong; Shi, Xuan; Gangwani, Rita A.; Iu, Lawrence P.; Fung, Nicholas S.; Li, Qing; Ng, Alex; Li, Xiaoxin

doi:10.1097/iae.0000000000001614

Cited by 11 publications

(14 citation statements)

References 17 publications

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“…Similarly, successful anatomical outcomes in form of resolution of macular oedema or subretinal uid with single session treatment was observed in nine patients (82%) at twelve weeks follow-up and complete resolution at six-month follow-up in all patients with additional session of half uence PDT. Similar positive results were also seen with half uence PDT in other choroidal pathologies like central serous chorioretinopathy and polypoidal choroidal vasculopathy which also predominantly affect choroidal vascular permeability [12,13].…”

Section: Discussionsupporting

confidence: 60%

Half Fluence Photodynamic Therapy in Peripapillary Circumscribed Choroidal Hemangiomas

Kumar¹,

Kumar²,

Mishra³

et al. 2021

Preprint

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PurposeTo evaluate the safety and efficacy of half fluence photodynamic therapy (PDT) as treatment for symptomatic peripapillary circumscribed choroidal haemangiomas (CCHs). MethodsIn this prospective, interventional case series; 11 patients with symptomatic peripapillary CCHs presenting to a single centre were treated with half fluence PDT using verteporfin 6 mg/m2 with fluence of 25 mJ/cm2 (standard is 50 mJ/cm2) and other standard settings. Patients were evaluated at baseline, four weeks, twelve weeks and twenty-four weeks post-PDT treatment with best corrected visual acuity (BCVA), ultrasonography, spectral domain- optical coherence tomography (SD-OCT), visual evoked potential and angiographic studies. ResultsEleven patients with peripapillary CCHs received half fluence PDT. The BCVA significantly improved to 0.558 + 0.118 at four weeks post treatment (P=0.014), to 0.494 + 0.114 at twelve weeks (P=0.006) and 0.441 + 0.125 at twenty-four weeks (P=0.007) from baseline levels of 1.017 + 0.075 on log MAR scales. Similar improvement was observed in central macular thickness (CMT) of 78.50 + 13.73 um(P=0.001) at four weeks; 114.70 + 27.73 um(P=0.003) at twelve weeks and 174.60 + 23.13 um(P=0.001) at twenty-four weeks post treatment. A single session of re-treatment was required in 18%(n=2) of patients which also showed complete resolution at last follow-up. No complications were observed without any significant change in retinal nerve fibre layer (RNFL) thickness at six months follow-up(P=0.088).ConclusionsHalf fluence PDT can be an effective and safe treatment option for peripapillary CCHs which results in both anatomical and functional improvements with no observable complications.

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Section: Discussionsupporting

confidence: 60%

Half Fluence Photodynamic Therapy in Peripapillary Circumscribed Choroidal Hemangiomas

Kumar¹,

Kumar²,

Mishra³

et al. 2021

Preprint

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“…Therefore, it can be concluded that half-dose (or half-fluence) PDT should be the treatment of choice for chronic CSC [18][19][20][21][22]. For the treatment of PCV, half-dose PDT has also been found to have a similar efficacy as full-dose PDT when both treatments are combined with intravitreal injections with anti-vascular growth factor inhibitors (VEGFs) [23].…”

Section: Reduced Settings: the Rationale And The Evidencementioning

confidence: 99%

“…2). In PCV patients, many clinicians perform PDT at the standard settings [39,43], but half-dose PDT may also be considered [23]. No significant improvement in BCVA has been reported after PDT monotherapy [44].…”

Section: Specific Considerations When Treating Polypoidal Choroidal Vmentioning

confidence: 99%

Photodynamic Therapy for Chorioretinal Diseases: A Practical Approach

et al. 2020

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Photodynamic therapy (PDT) using verteporfin (VisudyneÒ; Bausch ? Lomb) is a treatment that is widely used to elicit cell and tissue death. In ophthalmology, PDT targets choroidal vascular abnormalities and induces selective occlusion of vessels. PDT was originally used in combination with full-dose verteporfin to treat neovascular age-related macular degeneration.Since the introduction of treatment with vascular endothelial growth factor receptor inhibitors, the clinical targets of PDT have shifted to other chorioretinal conditions, such as central serous chorioretinopathy, polypoidal choroidal vasculopathy, and choroidal hemangioma. In recent years, clinical studies have facilitated the optimization of treatment outcomes through changes in protocols, including the introduction of reduced treatment settings, such as PDT with half-dose verteporfin and half-fluence PDT. Here, we review PDT and its use for chorioretinal diseases from a practical perspective.Patients should be adequately informed to avoid direct sunlight after treatment, and side effects during and after PDT are rare.

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“…68,69 Another study examined half-fluence PDT; results suggested that it is effective for single polypoidal lesions and may reduce harm to the RPE and choriocapillaris. 70 Treating PCV in Canada There is no clear evidence at this time to support first-line agent recommendations for this indication. In light of the PLANET results showing that aflibercept monotherapy achieved good responses in the majority of PCV patients, one option could be treatment with 3 monthly doses of aflibercept.…”

Section: Photodynamic Therapymentioning

confidence: 99%

Polypoidal choroidal vasculopathy in Canada

Lam

Choudhry

Wong

2020

Canadian Journal of Ophthalmology

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One-Year Results of Half- Versus Standard-Dose Photodynamic Therapy Combined With Ranibizumab for Polypoidal Choroidal Vasculopathy

Abstract: In general, hd-PDT was able to produce similar results as sd-PDT. Subgroup analysis revealed superior results with hd-PDT when baseline vision was 20/50 or better, or when there were three or less polyps on indocyanine green angiography.

Cited by 11 publications

References 17 publications

Half Fluence Photodynamic Therapy in Peripapillary Circumscribed Choroidal Hemangiomas

Half Fluence Photodynamic Therapy in Peripapillary Circumscribed Choroidal Hemangiomas

Photodynamic Therapy for Chorioretinal Diseases: A Practical Approach

Polypoidal choroidal vasculopathy in Canada

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