One-Year Results of Intravitreal Ranibizumab with or without Photodynamic Therapy for Polypoidal Choroidal Vasculopathy

Abstract

Purpose: To evaluate the safety and efficacy of intravitreal ranibizumab with or without photodynamic therapy (PDT) in the treatment of polypoidal choroidal vasculopathy (PCV) in Korean patients. Methods: A retrospective chart review of 22 patients (24 eyes) with PCV was conducted. Nine eyes were treated with intravitreal ranibizumab combined with a single session of PDT (group 1), and 15 eyes were treated only with ranibizumab (group 2). Such clinical evaluations as best-corrected Snellen visual acuity, central retinal thickness (CRT) by optical coherence tomography (OCT), fluorescein angiography (FA) and indocyanine green angiography (ICGA) were done at baseline, 1, 3, 6, 9 and 12 months after the first injections. Ranibizumab was reinjected on an as-needed basis guided by OCT, FA and ICGA, or at the doctor’s discretion. Results: The mean follow-up duration was 22.5 months (range 12–37). The mean best-corrected visual acuity (logMAR) improved, and the mean CRT decreased throughout 12 months in both groups; no statistically significant difference between the groups was found (p = 0.327, p = 0.073, respectively). The number of ranibizumab injections was not significantly different either (p = 0.555). Conclusions: Intravitreal ranibizumab with or without PDT for PCV in Korean patients resulted in visual and anatomical improvement over the 1-year follow-up period.

Comparison between 1-year outcomes of aflibercept with and without photodynamic therapy for polypoidal choroidal vasculopathy: Retrospective observation study

“…For example, the EVEREST study prospectively compared the 6-month outcomes of anti-VEGF monotherapy and combination therapy and found that the latter was statistically superior in terms of achieving complete polyp regression and reducing CRT, with no significant differences in visual acuity [32]. During a 12-month retrospective observation in another study, both combination therapy and monotherapy were found to improve visual acuity and reduce CRT, with no significant intergroup differences; additionally, fewer injections were required in the combination group [33]. As in these previous studies, the current study observed similar outcomes and a lack of adverse events with combination therapy and IAI monotherapy.…”

Effectiveness of intravitreal ranibizumab in exudative age-related macular degeneration (AMD): comparison between typical neovascular AMD and polypoidal choroidal vasculopathy over a 1 year follow-up

“…In addition, our results showed a significant increase in the mean BCVA in patients with tAMD, and a modest improvement in those with PCV. On the other hand, Song et al [25] reported that IVR without PDT for PCV in Korean patients resulted in visual and anatomical significant improvements over a 1-year follow-up period.…”

Polypoidal Choroidal Vasculopathy: Clinical Features and Genetic Predisposition

“…Some studies reported that the polypoidal lesions of PCV were barely resolved by anti-VEGF monotherapy, which might explain the limited efficacy of IVR against PCV [138,139,140]. However, Song et al [141] reported that IVR without PDT for PCV in Korean patients resulted in significant visual and anatomical improvements over a 1-year follow-up period, and other reports suggested that the disappearance of the polypoidal lesions occurred at a high rate in PCV cases after anti-VEGF monotherapy [74,142,143]. A recent review suggested an overall improvement of the VA of PCV patients using IVR [144], and a most recent multicenter randomized controlled trial (LAPTOP study) revealed that IVR monotherapy achieved a significantly better visual prognosis than PDT monotherapy in PCV patients [145].…”