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Published on: October 27, 2014
HALF-DOSE PHOTODYNAMIC THERAPY COMBINED WITH BEVACIZUMAB FOR POLYPOIDAL CHOROIDAL VASCULOPATHY
1Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Purpose:
To evaluate the efficacy of half-dose photodynamic therapy (PDT) combined with intravitreal bevacizumab (IVB) for polypoidal choroidal vasculopathy.
Methods:
For this retrospective comparative study, data from 57 patients (63 eyes) with at least 12 months of follow-up were reviewed. Full-dose or half-dose PDT combined with a single IVB treatment was performed according to the time period. From 3 months after the initial combination treatment, retreatment was performed mainly using anti-vascular endothelial growth factor injections on an as-needed basis.
Results:
Consecutively, 33 eyes were treated with full-dose PDT/IVB and 30 eyes with half-dose PDT/IVB. At Month 3, half-dose PDT/IVB induced negligible damage to the physiologic choroid but was inferior to full-dose PDT/IVB in achieving complete polyp closure (43.3% vs. 72.7%, P = 0.018) and improving mean best-corrected visual acuity (20/66 vs. 20/43, P = 0.020). At Month 12, the half-dose group achieved comparable visual improvement (20/51 vs. 20/40, P = 0.254) but required more additional injections (a mean of 2.80 vs. 1.03, P = 0.004).
Conclusion:
Despite inferior efficacy in inducing polyp closure, half-dose PDT/IVB followed by additional injections showed promising visual outcomes while avoiding damage to the physiologic choroid. Further long-term study is needed to evaluate the efficacy of half-dose PDT plus anti-vascular endothelial growth factor for polypoidal choroidal vasculopathy.
