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Yukari Shirakata, Fumio Shiraga, Chieko Shiragami, Ayana Yamashita, Atsushi Fujiwara; Long-term results of laser photocoagulation sparing the papillomacular bundle for peripapillary polypoidal choroidal vasculopathy lesions. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6345.
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To evaluate the safety and effectiveness of laser photocoagulation for indocyanine green angiography (ICGA)-identified peripapillary polypoidal choroidal vasculopathy (PPCV) lesions.
Twenty-five consecutive PPCV eyes with serous retinal detachments in the macula, which were treated with direct laser photocoagulation, were retrospectively reviewed. No patient had undergone previous treatment for PCV. All 25 eyes were treated with multicolor red (659 nm) laser photocoagulation. The laser spot was focused on the retinal pigment epithelium underneath the detached retina to spare the papillomacular bundle. Laser photocoagulation targeted the entire ICGA-identified lesion, including both the polypoidal lesions and the branching vascular network.
The mean follow-up period after the first treatment was 43.9 months (range, 12-113months). The logMAR BCVA was stable or improved by ≥0.3 logMAR in 22 eyes (88.0%). Six cases had recurrent leakage requiring retreatment. Three of 6 cases required photodymanic therapy, resulting in visual acuity loss by ≥0.3 logMAR. The other 3 cases administered some sessions of intravitreal anti-VEGF agents, resulting in visual acuity stability. Nineteen (76.0%) of the 25 studied eyes required no additional treatment during follow-up.
For PPCV, laser photocoagulation was effective in maintaining or improving visual acuity with only a single treatment session over a long period, because laser photocoagulation was administered for all vascular lesions, sparing the papillomacular bundle.
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