Effects of personalized clinical therapy for polypoidal choroidal vasculopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

SunZuhua , LinBing , LiYingzi , 张逸夔 , 黄颖 , 周容 , 李明翰 ,  刘晓玲

The Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou 325027, China;

Corresponding author：

刘晓玲, Email: lxl@mail.eye.ac.cn

Keywords：

Choroid diseases/therapy; Photochemotherapy; Antibodies, monoclonal; Triamcinolone acetonide

DOI：

10.3760/cma.j.issn.1005-1015.2014.03.003

Video：

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Objective To observe the effects of personalized clinical therapy for polypoidal choroidal vasculopathy (PCV). Methods Eighty-six eyes of 79 patients with PCV were enrolled in this study. There were 60 males (65 eyes) and 19 females (21 eyes). The average age was (64.48±13.15) years old. Best corrected visual acuity (BCVA), slit lamp ophthalmoscopy, fundus photography, optical coherence tomography (OCT), fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA) were measured. The average BCVA was 0.19±0..20. There were three groups in this study including photodynamic therapy (PDT) group (group A, 45 eyes), PDT and intravitreal ranibizumab injection group (group B, 31 eyes), and PDT combined with sub-Tenon's capsule triamcinolone acetonide injection group (group C, 10 eyes). Follow up begun at 1 month after the treatment. 40 eyes in group A were followed up for 1 to 12 months with the average 3.27 months.28 eyes in group B were followed up for 1 to 36 months with the average 6.68 months. 9 eyes in group C were followed up for 1 to 12 months with the average 5.67 months. Patients with recurrent or worsen lesions were followed by FFA or ICGA. Pre- and post-treatment BCVA and retinal thickness of the fovea were comparatively analyzed. Results All eyes (100.0%) in group A, 20 eyes (64.52%) in group B and 9 eyes (90.00%) in group C received treatment only once. The mean BCVA at 1 month after treatment was significantly increased than the pre-treatment BCVA in all 3 groups (t=2.061, 3.262, 3.258; P<0.05), but no significant difference was found between the 3 groups (t=1.345, 0.683, 0.168; P>0.05). Compared to pre-treatment measures, the mean retinal thickness of the fovea was significantly decreased in group A and group B (t=2.239, 4.334; P<0.05), but not changed in group C (t=2.286, P>0.05) at 1 month after treatment. Thirteen eyes in group A were followed by FFA and (or) ICGA, which showed that there were 3 eyes with complete closed PCV and alleviated pigment epithelial detachment (PED), 4 eyes with partial closed PCV, 3 eyes with stable PCV and 3 eyes with worsen PCV. Ten eyes in group B were followed by FFA and (or) ICGA, which showed that there were 3 eyes with complete closed PCV, 3 eyes with partial closed PCV, 4 eyes with recurrence PCV. Five eyes in group C were followed by FFA and (or) ICGA, which showed that there were 4 eyes with complete closed PCV, 1 eyes with recurrence PCV. Conclusion All 3 therapy strategies can stop or reduce PCV leakage and improve the visual acuity in some degree.

Citation： SunZuhua, LinBing, LiYingzi. Effects of personalized clinical therapy for polypoidal choroidal vasculopathy. Chinese Journal of Ocular Fundus Diseases, 2014, 30(3): 235-240. doi: 10.3760/cma.j.issn.1005-1015.2014.03.003 Copy

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15.	Jermak CM,Dellacroce JT,Hefez J,et al.Triamcinolone acetonidein ocular therapeutics[J].Surv Ophthalmol,2007,52:503-522.
16.	Lai TY,Lam CP,Luk FO,et al.Photodynamic therapy with or without intravitreal triamcinolone acetonide for symptomatic polypoidal choroidal vasculopathy[J].J Ocul Pharmacol Ther,2010,26:91-95.
17.	沈朝兰,李楚,夏仁春,等.光动力疗法联合玻璃体腔注射抗血管内皮生长因子制剂与单纯光动力疗法治疗息肉样脉络膜血管病变的系统评价[J].中华眼底病杂志,2012,5:507-514.

1. 曾春梅,文勇,成旋. 特发性息肉样脉络膜血管病变的治疗进展[J].眼科新进展, 2013,33: 694-696.
2. Mitamura Y,Kubota-Taniai M,Okada K,et al.Comparison of photodynamic therapy to transpupillary thermotherapy for polypoidal choroidal vasculopathy[J]. Eye(Lond),2009,23:67-72.
3. Yannuzzi LA, Sorenson J, Spaide RF,et al. Idiopathic polypoidal choroidal vasculopathy (IPCV)[J]. Retina,1990,10:1-8.
4. Spaide RF, Yannuzzi LA, Slakter JS, et al. Indocyanine green videoangiography of idiopathic choroidal vasculopathy[J]. Retina, 1995,15:100-110.
5. Yannuzzi LA, Ciardella A, Spaide RF,et al. The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy[J]. Arch Ophthalmol, 1997,115:478-485.
6. 文峰.有关息肉样脉络膜血管病变诊治的讨论[J].眼科,2007,16:373-377.
7. Coppens G,Spielberg L,Leys A.Polypoidal choroidal vasculopathy,diagnosis and management[J].Bull Soc Belge Ophtalmol,2011,317:39-44.
8. Spaide RF,Donsoff I,Lam DL,et al.Treatment of polypoidal choroidal vasculopathy with photodynamic therapy[J].Retina,2012,32 Suppl: S529-535.
9. Lee MW,Yeo I,Wong D,et al.Photodynamic therapy with verteporfin for polypoidal choroidal vasculopathy[J].Eye(Lond),2009,23:1417-1422.
10. Hikichi T,Higuchi M,Matsushita T,et al.One-year results of three monthly ranibizumab injections and as-needed reinjections for polypoidal choroidal vasculopathy in Japanese patients[J].Am J Ophthalmol,2012,154:117-124.
11. Maruko I,Iida T,Sugano Y,et al.Subfoveal retinal and choroidal thickness after verteporfin photodynamic therapy for polypoidal choroidal vasculopathy[J]. Am J Ophthalmol,2011,151:594-603.
12. 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.
13. Romano MR,Cipollone U,Semeraro F,et al. Combined photodynamic therapy and intravitreal bevacizumab for idiopathic polypoidal choroida lvasculopathy: one-year follow-up[J].Clin Ophthalmol,2010,21:1237-1241.
14. Leal S,Silva R,Figueira J,et al.Photodynamic therapy with verteporfin in polypoidal choroidal vasculopathy: results after 3 years of follow-up[J].Retina,2010,30:1197-1205.
15. Jermak CM,Dellacroce JT,Hefez J,et al.Triamcinolone acetonidein ocular therapeutics[J].Surv Ophthalmol,2007,52:503-522.
16. Lai TY,Lam CP,Luk FO,et al.Photodynamic therapy with or without intravitreal triamcinolone acetonide for symptomatic polypoidal choroidal vasculopathy[J].J Ocul Pharmacol Ther,2010,26:91-95.
17. 沈朝兰,李楚,夏仁春,等.光动力疗法联合玻璃体腔注射抗血管内皮生长因子制剂与单纯光动力疗法治疗息肉样脉络膜血管病变的系统评价[J].中华眼底病杂志,2012,5:507-514.

Chinese Journal of Ocular Fundus Diseases

Effects of personalized clinical therapy for polypoidal choroidal vasculopathy

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