Photodynamic therapy in combination with ranibizumab versus ranibizumab monotherapy for polypoidal choroidal...

To perform a systematic review and meta-analysis to compare the outcome and serious adverse effects of intravitreal ranibizumab (IVR) monotherapy vs. combined treatment of IVR and photodynamic therapy (PDT) on polypoidal choroidal vasculopathy (PCV).

A computerized online search was performed using PubMed, EMBASE, Cochrane Library, Web of Science and China National Knowledge Infrastructure (CNKI) database. The quality of included studies was evaluated according to the Newcastle-Ottawa Scale. Stata 11.0 software was used to do the Meta-analysis.

After a detailed systematic review, 4 articles (5 study samples) were included for this meta-analysis. PCV eyes treated with PDT combined with IVR achieved better best-corrected visual acuity (BCVA) than IVR monotherapy group throughout a follow-up of 12(th) month (weight mean difference [WMD] in BCVA, 0.132; 95% CI, 0.029-0.234, p=0.012). Further meta-analysis including studies with 24-month follow up period showed that BCVA at 24(th) month was also better in the combined treatment group than the monotherapy group (WMD in BCVA=0.234; 95% CI, 0.071-0.398, p=0.005). There were no significant differences both in serious ocular adverse effects and non-ocular adverse effects (p>0.05) between two groups.

Treatment of PCV by PDT combine with IVR is valuable in improving visual acuity and maintaining long term effectiveness. Given the inherent limitations of the included research, future studies are needed to further validate and update the findings in this area.