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Marc J. Sirks, Helena Margaret Anthonia Feenstra, Florentine R. de Vries, Greet Dijkman, Camiel J F Boon, Elon H.C. van Dijk; Results of focal photocoagulation in polypoidal choroidal vasculopathy patients from a Dutch referral center. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3768 – F0189.
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© ARVO (1962-2015); The Authors (2016-present)
To report the outcomes of focal thermal laser photocoagulation in polypoidal choroidal vasculopathy (PCV) patients from a Dutch referral center.
We describe a retrospective series of 24 eyes with indocyanine green angiography (ICGA)-proven PCV who had received focal laser photocoagulation. Inclusion criteria were: 1) the presence of either one or a cluster of extrafoveal polyps in the early phase of ICGA, with or without a co-existing neovascular network, 2) the presence of visual symptoms, and 3) the performance of focal laser photocoagulation, but no intravitreal injections with anti-vascular endothelial growth factor (VEGF) medication for at least 6 weeks before laser photocoagulation.
Twenty-four eyes of 22 patients were included. The mean age of patients was 72 years, with a female predominance (82%). The most common clinical features at presentation were exudates (88%), either serous or hemorrhagic pigment epithelial detachments (PEDs) (58%), and (sub)retinal hemorrhages (46%). During the mean total follow-up of more than 2 years, focal laser photocoagulation was applied once in 14 eyes (58%), and multiple times in 10 eyes (42%). Three months after laser photocoagulation, exudates were only seen in 17% of cases, serous or hemorrhagic PEDs in 4%, and hemorrhages in 4%. Over the first 3 months following laser photocoagulation, best-corrected visual acuity (BCVA) in Snellen improved 2 lines or more in 10 eyes (42%), decreased 2 lines or more in 4 eyes (16%), and remained stable (≤1 line change) in 10 eyes (42%). Only 5 remaining polyps were observed at the visit at 3 months after treatment and only 1 polyp was seen at 1 year after treatment. During the mean follow-up of 27 months, 7 of the 24 eyes (29%) had a polyp recurrence.
We observed a marked decrease of exudates, PEDs, and subretinal hemorrhages after focal laser photocoagulation in eyes with extrafoveal PCV, with a recurrence of polyps in only 25% of our cases, with a mean follow-up of 2 years. Visual acuity improved or stabilized in the majority of eyes. Monotherapy with focal laser photocoagulation may therefore still be a treatment option in PCV patients for whom photodynamic therapy or anti-VEGF medication is not available or for whom an intravitreal anti-VEGF injections treatment regimen is too intensive.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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