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Y. Nomura, A. Iriyama, R. Obata, Y. Tamaki, Y. Yanagi; Short Term Effect of Reduced Fluence Photodynamic Therapy for Polypoidal Choroidal Vasculopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):518.
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© ARVO (1962-2015); The Authors (2016-present)
This is a retrospective, interventional case series. Thirty-four eyes of 34 consecutive patients with the definite diagnosis of PCV who received PDT as an initial treatment between August 2007 and July 2009 were included in this study. Fourteen patients received RFPDT (25J/cm2) and 20 patients received SFPDT (50J/cm2). Main outcome measures were change in logarithm of minimal angle of resolution (logMAR) best-corrected visual acuity (VA), the proportion eyes with total regression of the polyps in indocyanine green angiography (ICGA) and the retreatment rate at three months after initial PDT. Choroidal hypoperfusion in ICGA and complication were also investigated. Students’ t-tests and Fisher’s exact probability tests were used for statistical analysis. RFPDT was performed with approval from the University of Tokyo School of Medicine Institutional Review Board.
At baseline, there was no difference in age or gender or the greatest linear dimension (GLD), logMAR VA in RFPDT was significantly better than that in SFPDT (0.30±0.29 vs 0.58±0.22, P=0.002). At three months after PDT, there was no significant difference in the change of visual acuity (0.08±0.29 logMAR units in RFPDT vs -0.02±0.2 logMAR units in SFPDT (p=0.87). The proportion of eyes with total regression of polyps in RFPDT was 36% (5/14), significantly lower than that in SFPDT (85% (17/20), p=0.005). Retreatment rate in RFPDT was 50% (7/14), significantly higher than that in SFPDT (15% (3/20), p=0.03). Choroidal hypoperfusion in RFPDT was observed in three (21%) patients, significantly fewer than those in SFPDT (16 (80%), p=0.001). Massive subretinal hemorrhage after PDT was observed in two (14%) patients in RFPDT, whereas no complications were observed in SFPDT. Posterior juxtascleral triamcinolone acetonide injection was combined in nineteen (95%) patients in SFPDT and in two (14%) in RFPDT (p<0.001).
RFPDT is well-tolerated in PCV, however, seems less effective in diminishing polypoidal lesions when compared with that of SFPDT.
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