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Hyung-Woo Kwak, Ji Ho Yang, Jung Bin Han, Seung-Young Yu; Five-Year Results of Combined Treatment for Polypoidal Choroidal Vasculopathy: Verteporfin PDT and Intravitreal Anti-VEGF. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4047.
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To evaluate the 5-year efficacy of photodynamic therapy (PDT) combined with intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) in patients with polypoidal choroidal vasculopathy (PCV).
Twenty-seven eyes of 27 patients with symptomatic PCV in treatment naïve eyes followed up for ≥60 months after PDT and anti-VEGF combination therapy were retrospectively reviewed. The patients received intravitreal anti-VEGF (1.25 mg bevacizumab or 0.5 mg ranibizumab) within 7 days after PDT. All clinical data, including baseline characteristics; imaging data from fluorescein angiography, indocyanine green angiography, and optical coherence tomography; presence of recurrence; and best-corrected visual acuity (BCVA) were investigated.
The mean baseline BCVA was 0.67±0.36 logMAR, 0.34±0.28 logMAR at 12 months (p=0.001 vs. baseline) and 0.59±0.49 at 60 months (p=0.197). On the final evaluation at 60 months, the mean BCVA was improved in 11 eyes (40.74%), stable in 8 eyes (29.6%), and decreased in 8 eyes (29.6%). Mean BCVA was significantly improved up to 12 months and then improvement slowly decreased over 60 months. Significant improvement maintained until 36 months (p=0.004 ). The mean CFT was 346±47.6 at baseline and significantly decreased to 193.4±19.0 at 12 months and the final CFT at 60 months was 231.2±25.1. PDT was administered 2.30±0.71 times and anti-VEGF injected 9.45±1.21 times over the 60-month period. The baseline PED volume showed positive correlation with BCVA change at final visit (p=0.034, r=1.051).
Significant visual improvement by combined PDT and anti-VEGF injection was maintained up to the third year of initial treatment; however, utmost improvement decreased after the first year. After 60 months, 70.4% of PCV patients showed stable or improved BCVA. The baseline PED volume was significantly correlated with long-term visual outcome.
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