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Factors influencing visual outcome of polypoidal choroidal vasculopathy one year after photodynamic therapy
Ryusaburo Mori1, Mitsuko Yuzawa, Zeon Lee
1Department of Ophthalmology, Nihon University, School of Medicine, Surugadai Nihon University Hospital, 1-8-13 Surugadai, Kanda, Chiyoda-ku, Tokyo, Japan.
Background:
Polypoidal choroidal vasculopathy (PCV) is considered to be a good indication for photodynamic therapy (PDT). We evaluated pre-PDT factors predicting better visual acuity (VA) 1 year after PDT in patients with PCV.
Methods:
We evaluated 181 eyes of 181 patients who underwent PDT and were followed up for 1 year. Additional treatments, if needed, were given every 3 months, with a maximum of four PDT sessions, for up to 9 months. We compared best-corrected VA (BCVA) 1 year after PDT with that before PDT. Pre-PDT factors favoring better BCVA 1 year after PDT were evaluated using stepwise multiple regression analysis.
Results:
Mean BCVA improved from 0.29 +/- 0.15 before PDT to 0.43 +/- 0.32 1 year after PDT (p < 0.001). BCVA improved in 55 eyes (30.4%), and was maintained in 110 (60.8%). Pre-PDT factors predicting better BCVA at 1 year were better initial BCVA (beta = 0.271, p < 0.001) within our eligibility criteria up to 0.6, a relatively small diameter of a network of vessels plus polypoidal lesions on indocyanine green angiography (beta = 0.249, p < 0.001), and the absence of a polypoidal lesion under the fovea (beta = 0.175, p = 0.011).
Conclusion:
Better BCVA can be expected 1 year after PDT in eyes with PCV showing better initial BCVA, relatively small lesions on indocyanine green angiography, and no subfoveal polypoidal lesion before PDT.