Abstract
Purpose:
To investigate the influence of photodynamic therapy (PDT) and combination of PDT and ranibizumab on aqueous humor levels of vascular endothelial growth factor (VEGF) in polypoidal choroidal vasculopathy (PCV).
Methods:
Prospective, randomized clinical trial. We included twenty eyes with treatment-naïve PCV and 20 eyes undergoing cataract surgery as controls. Eyes with PCV were randomized to treatment with PDT alone or to a combination of ranibizumab and PDT on same day. During 3 months of follow-up, retreatment was not performed. Aqueous humor samples were collected at baseline and at 1 week, 1 month and 3 months after treatment in PCV group and during cataract surgery in the control group. VEGF levels were measured using multiplex bead immunoassay.
Results:
At baseline, concentrations of VEGF were significantly increased in PCV eyes compared with control eyes. A significant decrease in VEGF levels were found at 1 week after PDT treatment (n=8), and at all time points after combination treatment (n=12). With combination treatment, VEGF levels were decreased to values below the detection limit in all eyes at 1 week and 1 month, and in 7 of 12 eyes at 3 months.
Conclusions:
Decreased levels of VEGF detected 1 week after PDT for PCV seems to reflect acute damage of vascular endothelial cells, one of VEGF expression sites. Concomitant ranibizumab resulted in a further decrease in VEGF expression to negligible levels. This effect persisted for at least 1 month and as long as 3 months in more than half of the cases.
Keywords: 688 retina •
412 age-related macular degeneration •
748 vascular endothelial growth factor