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Pietro Frascio, Massimo Nicolò, Raffaella Rosa, Maria Musolino, Carlo Enrico Traverso; Half-dose photodynamic therapy alone or combined with ranibizumab in Polypoidal Choroidal Vasculopathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5383.
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To evaluate the efficacy and safety of Half-Dose Photodynamic Therapy (HD-PDT) alone or combined with ranibizumab in patients affected by polypoidal choroidal vasculopathy (PCV).
PCV is characterized by the presence of aneurismal polypoidal lesions in the choroidal vasculature. The polypoidal lesions are best detected with indocyanine green angiography (ICGA). Standard photodynamic therapy (PDT) with verteporfin and/or intravitreal injections of ranibizumab are the most widely described treatment modalities for PCV. The standard dose of PDT might be associated with possible adverse effects on the choriocapillaris surrounding the treatment zone due to up-regulation of vascular endothelial growth factor (VEGF).<br /> In the treatment of other diseases HD-PDT showed similar results compared to standard PDT with significant fewer adverse events.<br /> To our knowledge no studies have been conducted on the efficacy and safety of HD -PDT in PCV.<br /> Patients with PCV diagnosis were selected from the I-maculaweb database selecting patients with IPCV diagnosis. Best-corrected visual acuity (BCVA) assessed with ETDRS letters score and central retinal thickness (CRT) were evaluated at baseline and at the last follow-up visit.
Thirteen patients (13 eyes), 12 caucasian and 1 hispanic, 5 males and 8 females, met the diagnostic requirements. Mean age was 68±10,93years. Mean follow-up was 12,65±10,40 months. Seven eyes were treated with HD-PDT as monotherapy with no additional therapy needed for the entire duration of the follow-up. Three eyes initially treated with HD-PDT, underwent intravitreal injection of ranibizumab (mean 4±2,6) as a rescue treatment due to persistent subretinal fluid. Three eyes were treated first with intravitreal injections of ranibizumab (mean 4,5±1,7) later receiving one single session of HD-PDT as a rescue treatment due to persistent subretinal fluid. Overall mean number of ETDRS letter score at baseline and last follow-up visit was 51,29±25,83 and 64,29±17,97 (p=0,0121; paired t test) respectively. Mean CRT at baseline and last follow-up visit was 292,3±37,27 and 277,6±33,90 respectively (p=0,2; paired t test). No local and systemic adverse events were experienced after the HD-PDT.
Our data show that HD-PDT alone or combined to ranibizumab intravitreal injections may be an effective and safe therapy for the treatment of PCV.
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