Photodynamic Therapy With Verteporfin for Polypoidal Choroidal Vasculopathy

Abstract

Abstract: : Purpose: To evaluate the efficacy of photodynamic therapy with verteporfin for polypoidal choroidal vasculopathy (PCV). Methods: In this retrospective study 25 eyes of 25 patients aged between 56 and 90 years (mean 72 years, SD 11 years) with PCV were included. In all eyes, indocyanine green (ICG) angiography revealed active lesions. At baseline and in three months intervals, visual acuity was measured and fluorescein and ICG angiography, as well as optical coherence tomography was performed. Standard photodynamic therapy (PDT) with verteporfin was performed. The laser spot size covered the active vascular lesion on ICG angiography plus an extra 1000 µm margin. Re–treatment was performed when ICG angiography revealed an active lesion. The follow–up period was 1 year. Results: Improvement of vision (≥ 3 lines) was achieved in 9 eyes (36%). Eleven eyes had stable vision (44%), and in 5 eyes (20%) the vision decreased (≥ 3 lines). In three eyes, multiple spots were treated. Multiple treatments were required in 15 eyes (60%). There were no treatment related side–effects. In three eyes, additional thermal photocoagulation or intravitreal triamcinolone injection was performed. Conclusions: This study indicates that stabilization or improvement of vision is achieved in the majority of eyes (80%) with PCV after PDT with verteporfin. Due to the frequent need for re–treatment, patients should be followed closely. Further studies with longer follow–up are warranted to investigate the long–term efficacy in PCV.

Keywords: choroid • neovascularization