Indocyanine Green Angiography (ICGA)-Guided Photodynamic Therapy (PDT) for Polypoidal Choroidal Vasculopathy (PCV) Patients: A Two Year Results

Abstract

Purpose: : We have already reported the short term (12 months) effectiveness of indocyanine green angiography (ICGA)-guided photodynamic therapy (PDT) for polypoidal choroidal vasculopathy (PCV). This study is to report the two year visual outcomes of ICGA-guided PDT for PCV patients.

Methods: : A retrospective analysis of the clinical and angiographic data related to 44 eyes of 41 PCV patients (male 28, female 13, average age 72.6±7.5) who were followed up 18 months or more was carried out. PDT was done only for vascular lesions that were observed on ICGA (ICGA-guided PDT). PCV patients who had exudative AMD in the contra lateral eye were defined as bilateral cases.

Results: : The average number of PDT was 1.34 by 12 month and 1.60 by 24 month. Between 12 month and 24 month, 10 out of 44 eyes required re-treatment. Although the mean visual acuity (VA) of pre-PDT (log MAR; 0.63±0.40) was improved to 0.57±0.80 at 12 month after PDT, it was significantly declined to 0.67±0.45 (p=0.047) at 24 months. At 12 month after PDT, 37 eyes were improved or unchanged in VA, however, 9 of those 37 eyes showed deterioration of VA after that. Among the 28 eyes that were improved or stabilized in VA over 24 months after initial PDT, 7 eyes were bilateral cases. In contrast, we found 10 eyes were bilateral in 17 eyes that lost VA after PDT. The mean VA of bilateral (17 eyes) but not unilateral (27 eyes) cases was significantly decreased at 24 month after PDT.

Conclusions: : PDT is an effective treatment against PCV in short term. However, further careful observation is recommended even in those effective cases especially in bilateral AMD.

Keywords: photodynamic therapy • age-related macular degeneration