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Hae Min Kang, Naeun Lee, Hyoung Jun Koh; Photodynamic therapy, anti-vascular endothelial growth factor therapy, and combination therapy for polypoidal choroidal vasculopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3789.
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To compare treatment outcomes of photodynamic therapy (PDT), anti-vascular endothelial growth factor (VEGF) therapy, and combination therapy (PDT with the anti-VEGF therapy ranibizumab) for polypoidal choroidal vasculopathy (PCV).
Among 62 eyes (62 patients) retrospectively reviewed, 19 eyes received PDT only (PDT group), 23 received intravitreal ranibizumab injections only (anti-VEGF group), and 20 received combined PDT with anti-VEGF therapy (combination group). Best-corrected visual acuity [BCVA, logarithm of minimum angle resolution (logMAR)] and recurrence after treatment were compared at baseline and 1, 3, 6, 12, and 24 months.
Mean baseline BCVA was 0.68±0.36 logMAR (20/95 Snellen equivalent) in PDT group, 0.67±0.43 logMAR (20/93 Snellen equivalent) in anti-VEGF group, and 0.64±0.35 logMAR (20/87 Snellen equivalent; P=0.723) in combination group. Both PDT and combination groups maintained improvement throughout 24 months, compared with baseline. The mean visual improvement at 24 months was 0.25 logMAR (P=0.013) in the combination group and 0.08 logMAR (P=0.183) in the PDT group, respectively. The anti-VEGF group maintained improvement until 12 months, then had a mean BCVA that was worse than baseline (P=0.673) at 24 months. Combination group mean BCVA was better than those of the PDT group and the anti-VEGF group at each follow-up. During 24-month follow-up, nine PDT group eyes (47.4%), 15 anti-VEGF group eyes (64.9%), and 10 combination group eyes (50.0%) showed at least one recurrence.
Visual outcomes but not recurrence rates were better with combination therapy compared to PDT and anti-VEGF monotherapy for 24-month follow-up.
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