Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

WangJing ,  ChenYouxin , WangErqian , 张古沐阳

Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China;

Corresponding author：

ChenYouxin, Email: chenyouxin@medmail.com.cn

Keywords：

Choroid diseases/therapy; Photochemotherapy; Antibodies,monoclonal/therapeutic use

DOI：

10.3760/cma.j.issn.1005-1015.2014.01.014

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Objective To evaluate the 3-year efficacy of photodynamic therapy (PDT) in patients with polypoidal choroidal vasculopathy (PCV). Methods This is a retrospective, uncontrolled case series study. Thirty-two eyes of 29 patients with PCV were enrolled. All patients were primarily treated with the first conventional PDT. For the eye with active polypoida, residual or exudative lesions in 6 month after PDT, PDT combined with intravitreal anti vascular endothelial growth factor (VEGF)or simple vitreous injection of anti VEGF therapy were used. All the patients were followed up for at least 3 years with the mean follow-up duration of 43.64±10.84 months. The best-corrected visual acuity (BCVA) in 1, 3, 6, 12, 24 and 36 months after the primary PDT, PCV recurrence rates and number of treatments were followed and analyzed. The BCVA was converted into a logarithm of the minimal angle of resolution (logMAR) for statistical analysis. Results During the 1, 3, 6, 12 months after the primary PDT, the mean BCVA were all improved with statistically significant difference(t=2.27, 4.57, 3.77, 2.37; P<0.05). During the 24 and 36 months after PDT, the mean BCVA was decreased without statistically significant difference(t=-1.29, -0.81; P>0.05). On the final evaluation at 36 months, the mean BCVA was improved in 6 eyes(18.75%), stable in 14 eyes(43.75%), and decreased in 12 eyes(37.50%). During the follow-up time, recurrence of PCV in 24 eyes (75.00%), no recurrence in 8 eyes (25.00%). There was 1 recurrence in 12 eyes (50.00%), 2 recurrences in 9 eyes (37.50%), 3 recurrences in 3 eyes (12.50%). Initial recurrences were noted in 4 eyes (16.67%) within 12 months of baseline PDT treatment; in 11 eyes (45.83%) between 13 and 24 months; in 9 eyes (37.50%) between 25 and 36 months. The mean number of PDT and anti-VEGF was 1.86±1.04 and 4.95±3.92 in all patients, respectively. Conclusion The 3-year efficacy of PDT in patients with PCV was poor with low improvement of visual acuity and high recurrence rate of PCV.

Citation： WangJing, ChenYouxin, WangErqian. Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy. Chinese Journal of Ocular Fundus Diseases, 2014, 30(1): 54-58. doi: 10.3760/cma.j.issn.1005-1015.2014.01.014 Copy

1.	Tsuchiya D,Yamamoto T,Kawasaki R,et al.Two-year outcomes after hotodynamic therapy in age-related macular degeneration patients with or without polypoidal choroidal vasculopathy lesions[J].Retina,2009,29:960-965.
2.	Akaza E,Mori R,Yuzawa M.Long-term results of photodynamic therapy of polypoidal choroidal vasculopathy[J].Retina,2008,28:717-722.
3.	Gomi F,Ohji M,Sayanagi K,et al.One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients[J].Ophthalmology,2008,115:141-146.
4.	Hirami Y,Tsujikawa A,Otani A,et al.Hemorrhagic complications after photodynamic therapy for polypoidal choroidal vasculopathy[J].Retina,2007,27:335-341.
5.	金陈进,张燕,田臻,等.光动力疗法治疗息肉状脉络膜血管病变[J].中华眼科杂志,2007,43:642-645.
6.	Silva RM,Figueira J,Cachulo ML,et al.Polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin[J].Graefe's Arch Clin Exp Ophthalmol,2005,243:973-979.
7.	Chan WM,Lam DSC,Lai TY,et al.Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy:one-year results of a prospective case series[J].Ophthalmology,2004,111:1576-1584.
8.	Quaranta M,Mauget-Faÿsse M,Coscas G.Exudative idiopathic polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin[J].Am J Ophthalmol,2002,134:277-280.
9.	Spaide RF,Donsoff I,Lam DL,et al.Treatment of polypoidal choroidal vasculopathy with photodynamic therapy[J].Retina,2002,22:529-535.
10.	Koh A,Lee WK,Chen LJ,et al.Efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy[J].Retina,2012,32:1453-1464.
11.	Leal S,Silva R,Figueira J,et al.Photodynamic therapy with verteporin in polypoidal choroidal vasculopathy:results after 3 years of follow-up[J].Retina,2010,30:1197-1205.
12.	Holladay JT.Proper method for calculating average visual acuity[J].J Refract Surg,1997,13:388-391.
13.	Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin:one-year results of 2 randomized clinical trials-TAP report[J].Arch Ophthalmol,1999,117:1329-1345.
14.	Verteporfin in Photodynamic Therapy Study Group. Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration:two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization-Verteporfin in Photodynamic Therapy Report 2[J].Am J Ophthalmol,2001,131:541-560.
15.	Kim M,Kim K,Kim DG,et al.Two-year results of photodynamic therapy combined with intravitreal anti-vascular endothelial growth factor for polypoidal choroidal vasculopathy[J].Ophthalmologica,2011,226:205-213.
16.	Lee YA,Yang CH,Yang CM,et al.Photodynamic therapy with or without intravitreal bevacizumab for polypoidal choroidal vasculopathy:two years of follow-up[J].Am J Ophthalmol,2012,154:872-880.
17.	Nemoto R,Miura M,Iwasaki T,et al.Two-year follow-up of ranibizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy[J].Clin Ophthalmol,2012,6:1633-1638.
18.	Akaza E,Yuzawa M,Mori R.Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy[J].Jpn J Ophthalmol,2011,55:39-44.
19.	Saito M,Iida T,Kano M,et al.Five-year results of photodynamic therapy with and without supplementary antivascular endothelial growth factor treatment for polypoidal choroidal vasculopathy[J/OL].Graefe’s Arch Clin Exp Ophthalmol,2013,251:E1[2013-08-07].http://link.springer.com/article/10.1007%2Fs00417-013-2433-1..
20.	Akaza E,Yuzawa M,Matsumoto Y,et al.Role of photodynamic therapy in polypoidalchoroidal vasculopathy[J].Jpn J Ophthalmol,2007,51:270-277.
21.	Lee YH,Lee EK,Shin KS,et al.Intravitreal ranibizumab combined with verteporin photodynamic therapy for treating polypoidal choroidal vasculopathy[J].Retina,2011,31:1287-1293.
22.	Kim SJ,Yu HG.Efficacy of combined photodynamic therapy and intravitreal bevacizumab injection versus photodynamic therapy alone in polypoidal choroidal vasculopathy[J].Retina,2011,31:1827-1834.
23.	Hikichi T,Ohtsuka H,Higuchi M,et al.Factors predictive of visual acuity outcomes 1 year after photodynamic therapy in Japanese patients with polypoidal choroidal vasculopathy[J].Retina,2011,31:857-865.
24.	Tomita K,Tsujikawa A,Yamashiro K,et al.Treatment of polypoidal choroidal vasculopathy with photodynamic therapy combined with intravitreal injections of ranibizumab[J].Am J Ophthalmol,2012,153:68-80.
25.	Sato T,Kishi S,Matsumoto H,et al.Combined photodynamic therapy with verteporfin and intravitreal bevacizumab for polypoidal choroidal vasculopathy[J].Am J Ophthalmol, 2010,149:947-954.
26.	Gomi F,Sawa M,Wakabayashi T,et al.Efficacy of intravitreal bevacizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy[J].Am J Ophthalmol,2010,150:48-54.
27.	Kokame GT,Yeung L,Lai JC.Continuous anti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy:6-month results[J].Br J Ophthalmol,2010,94:297-301.
28.	Song MH,Ryu HW,Roh YJ,et al.One-year results of intravitreal ranibizumab with or without photodynamic therapy for polypoidal choroidal vasculopathy[J].Ophthalmologica,2011,226:119-126.
29.	Hikichi T,Higuchi M,Matsushita T,et al.Results of 2 years of treatment with as-needed ranibizumab reinjection for polypoidal choroidal vasculopathy[J].Br J Ophthalmol,2013,97:617-621.

1. Tsuchiya D,Yamamoto T,Kawasaki R,et al.Two-year outcomes after hotodynamic therapy in age-related macular degeneration patients with or without polypoidal choroidal vasculopathy lesions[J].Retina,2009,29:960-965.
2. Akaza E,Mori R,Yuzawa M.Long-term results of photodynamic therapy of polypoidal choroidal vasculopathy[J].Retina,2008,28:717-722.
3. Gomi F,Ohji M,Sayanagi K,et al.One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients[J].Ophthalmology,2008,115:141-146.
4. Hirami Y,Tsujikawa A,Otani A,et al.Hemorrhagic complications after photodynamic therapy for polypoidal choroidal vasculopathy[J].Retina,2007,27:335-341.
5. 金陈进,张燕,田臻,等.光动力疗法治疗息肉状脉络膜血管病变[J].中华眼科杂志,2007,43:642-645.
6. Silva RM,Figueira J,Cachulo ML,et al.Polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin[J].Graefe's Arch Clin Exp Ophthalmol,2005,243:973-979.
7. Chan WM,Lam DSC,Lai TY,et al.Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy:one-year results of a prospective case series[J].Ophthalmology,2004,111:1576-1584.
8. Quaranta M,Mauget-Faÿsse M,Coscas G.Exudative idiopathic polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin[J].Am J Ophthalmol,2002,134:277-280.
9. Spaide RF,Donsoff I,Lam DL,et al.Treatment of polypoidal choroidal vasculopathy with photodynamic therapy[J].Retina,2002,22:529-535.
10. Koh A,Lee WK,Chen LJ,et al.Efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy[J].Retina,2012,32:1453-1464.
11. Leal S,Silva R,Figueira J,et al.Photodynamic therapy with verteporin in polypoidal choroidal vasculopathy:results after 3 years of follow-up[J].Retina,2010,30:1197-1205.
12. Holladay JT.Proper method for calculating average visual acuity[J].J Refract Surg,1997,13:388-391.
13. Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin:one-year results of 2 randomized clinical trials-TAP report[J].Arch Ophthalmol,1999,117:1329-1345.
14. Verteporfin in Photodynamic Therapy Study Group. Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration:two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization-Verteporfin in Photodynamic Therapy Report 2[J].Am J Ophthalmol,2001,131:541-560.
15. Kim M,Kim K,Kim DG,et al.Two-year results of photodynamic therapy combined with intravitreal anti-vascular endothelial growth factor for polypoidal choroidal vasculopathy[J].Ophthalmologica,2011,226:205-213.
16. Lee YA,Yang CH,Yang CM,et al.Photodynamic therapy with or without intravitreal bevacizumab for polypoidal choroidal vasculopathy:two years of follow-up[J].Am J Ophthalmol,2012,154:872-880.
17. Nemoto R,Miura M,Iwasaki T,et al.Two-year follow-up of ranibizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy[J].Clin Ophthalmol,2012,6:1633-1638.
18. Akaza E,Yuzawa M,Mori R.Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy[J].Jpn J Ophthalmol,2011,55:39-44.
19. Saito M,Iida T,Kano M,et al.Five-year results of photodynamic therapy with and without supplementary antivascular endothelial growth factor treatment for polypoidal choroidal vasculopathy[J/OL].Graefe’s Arch Clin Exp Ophthalmol,2013,251:E1[2013-08-07].http://link.springer.com/article/10.1007%2Fs00417-013-2433-1..
20. Akaza E,Yuzawa M,Matsumoto Y,et al.Role of photodynamic therapy in polypoidalchoroidal vasculopathy[J].Jpn J Ophthalmol,2007,51:270-277.
21. Lee YH,Lee EK,Shin KS,et al.Intravitreal ranibizumab combined with verteporin photodynamic therapy for treating polypoidal choroidal vasculopathy[J].Retina,2011,31:1287-1293.
22. Kim SJ,Yu HG.Efficacy of combined photodynamic therapy and intravitreal bevacizumab injection versus photodynamic therapy alone in polypoidal choroidal vasculopathy[J].Retina,2011,31:1827-1834.
23. Hikichi T,Ohtsuka H,Higuchi M,et al.Factors predictive of visual acuity outcomes 1 year after photodynamic therapy in Japanese patients with polypoidal choroidal vasculopathy[J].Retina,2011,31:857-865.
24. Tomita K,Tsujikawa A,Yamashiro K,et al.Treatment of polypoidal choroidal vasculopathy with photodynamic therapy combined with intravitreal injections of ranibizumab[J].Am J Ophthalmol,2012,153:68-80.
25. Sato T,Kishi S,Matsumoto H,et al.Combined photodynamic therapy with verteporfin and intravitreal bevacizumab for polypoidal choroidal vasculopathy[J].Am J Ophthalmol, 2010,149:947-954.
26. Gomi F,Sawa M,Wakabayashi T,et al.Efficacy of intravitreal bevacizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy[J].Am J Ophthalmol,2010,150:48-54.
27. Kokame GT,Yeung L,Lai JC.Continuous anti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy:6-month results[J].Br J Ophthalmol,2010,94:297-301.
28. Song MH,Ryu HW,Roh YJ,et al.One-year results of intravitreal ranibizumab with or without photodynamic therapy for polypoidal choroidal vasculopathy[J].Ophthalmologica,2011,226:119-126.
29. Hikichi T,Higuchi M,Matsushita T,et al.Results of 2 years of treatment with as-needed ranibizumab reinjection for polypoidal choroidal vasculopathy[J].Br J Ophthalmol,2013,97:617-621.

Chinese Journal of Ocular Fundus Diseases

Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy

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