Abstract
Purpose
To evaluate the efficacy of photodynamic therapy (PDT) with verteporfin for polypoidal choroidal vasculopathy (PCV) in Korean patients.
Methods
Clinical data of patients who were treated with PDT for PCV and followed up for more than 6 months were collected from 14 hospitals around the country. The changes in the best corrected visual acuity, angiographic outcome, retinal thickness measured by optical coherence tomography (OCT), and adverse effects of treatment were evaluated.
Results
Eighty six patients (86 eyes) were recruited (male: 75.6%, age: 65.9±8.3 years, mean follow-up: 14.8±10.2 months). The mean logMAR visual acuity at baseline was 0.55±0.32 and did not show any statistically significant difference from the final mean logMAR visual acuity (0.53±0.54) (p =0.639). The mean treatment session number of PDT was 2±1.2. Visual acuity stabilized or improved in 70.9% of patients. Visual acuity improved by more than 2 lines in 33 eyes (38.4%) and worsened by more than 2 lines in 21 eyes (24.4%) of patients. Vascular leakage decreased in 62.5% of patients in fluorescein angiography and polypoidal lesions disappeared or were reduced in 57.3% of patients in indocyanine green angiography. There was no systemic adverse effect of PDT, but increased subretinal hemorrhage after PDT occurred in 10 eyes (11.6%).
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Figure 1.
Changes of visual acuity after photodynamic therapy in polypoidal choroidal vasculopathy. V.A=visual acuity.
![jkos-50-365f1.tif](/upload/SynapseXML/0035jkos/thumb/jkos-50-365f1.gif)
Figure 2.
Proportion of moderate (more than 3 lines) and severe (more than 6 lines) visual loss after photodynamic therapy in polypoidal choroidal vasculopathy. V.A=visual acuity.
![jkos-50-365f2.tif](/upload/SynapseXML/0035jkos/thumb/jkos-50-365f2.gif)
Figure 3.
Fluorescein angiographic outcomes of polypoidal choroidal vasculopathy after photodynamic therapy.
![jkos-50-365f3.tif](/upload/SynapseXML/0035jkos/thumb/jkos-50-365f3.gif)
Figure 4.
Final activities of polyp in indocyanine green angiography after photodynamic therapy in polypoidal choroidal vasculopathy.
![jkos-50-365f4.tif](/upload/SynapseXML/0035jkos/thumb/jkos-50-365f4.gif)
Figure 5.
Changes of central macular thickness (CMT) and total macular volume (TMV) in optical coherent tomogram after photodynamic therapy in polypoidal choroidal vasculopathy.
![jkos-50-365f5.tif](/upload/SynapseXML/0035jkos/thumb/jkos-50-365f5.gif)
Table 1.
Demographics and baseline characteristics of patients
No. of patients (n) | 86 |
---|---|
Age (years) | 65.9±8.3 |
Male/Female (%) | 65/21 (75.6%/24.4%) |
Right/Left eye (%) | 45/41 (52.3%/47.7%) |
Follow up (months) | 14.8±10.2 |
Location of polyp (%) | Subfovea-33 (38.4%), Juxtafovea-53 (61.6%) |
Number of polyps | 3.7±2.4 (range 1-15) |
Status of fellow eye | ARMD: 22, PCV: 4, Disciform scar: 1, |
Retinal detachment: 1, ERM: 1, POAG: 1 | |
Systemic disease | HTN: 18, DM: 9, Angina:1, Tbc: 1, |
Allergy:1, Stomach ca.: 1 | |
Number of PDT treatment | 2.0±1.2 (range 1-8) |
Baseline GLD (μm) | 2814.5±1194.8 |
Laser spot size at 1st PDT (μm) | 3706.3±1099 |
Bseline BCVA (mean± SD/median) | 0.55±0.32 LogMAR/0.5 LogMAR |
Final BCVA (mean± SD/median) | 0.53±0.54 LogMAR/0.395 LogMAR (p=0.693*) |
Table 2.
Comparison between subfoveal and juxtafoveal polypoidal choroidal vasculopthy
subfovea | juxtafovea | p* | |
---|---|---|---|
No. of Patients (n) | 33 | 53 | |
Age (years) | 68.2±8.2 | 64.6±8.2 | 0.053 |
Right/Left (eyes) | 17/16 | 28/25 | 0.905 |
Male/Female (eyes) | 28/5 | 37/16 | 0.13 |
Follow up (months) | 15.8±9.1 | 14.2±10.8 | 0.479 |
No. of Polyp | 4±2.96 | 3.5±2.15 | 0.396 |
No. of Retreatment | 2.24±1.28 | 1.87±1.19 | 0.172 |
Baseline BCVA (LogMAR) | 0.55±0.26 | 0.56±0.36 | 0.812 |
Final BCVA (LogMAR) | 0.61±0.61 | 0.48±0.49 | 0.282 |
Changes of BCVA (LogMAR) | −0.06±0.62 | 0.08±40.47 | 0.226 |
Baseline GLD (μm) | 2879.2±1090.8 | 2774.2±1263.8 | 0.694 |
Laser spot size at 1st PDT (μm) | 3792.9±1123.8 | 3652.4±1090.6 | 0.567 |
Final FAG activity (n) | n=32 | n=48 | 0.245 |
Complete regression | 3 (9.4%) | 13 (27.1%) | |
Partial regression | 13 (40.6%) | 21 (43.8%) | |
Stationary | 8 (25%) | 6 (12.5%) | |
Progression | 6 (18.8%) | 6 (12.5%) | |
Conversion to CNV | 2 (6.3%) | 2 (4.2%) | |
Final ICG activity of polyp (n) | n=22 | n=39 | 0.438 |
Complete regression | 6 (27.3%) | 13 (33.3%) | |
Partial regression | 5 (22.7%) | 11 (28.2%) | |
Stationary | 6 (27.3%) | 8 (20.5%) | |
Progression or new polyp | 3 (13.6%) | 5 (12.8%) | |
Conversion to CNV | 2 (9.1%) | 2 (5.1%) |