The study aim is to describe the clinical outcomes of patients with polypoidal choroidal vasculopathy (PCV) treated with focal argon laser photocoagulation and ranibizumab combination therapy.
Methods.
This study is a retrospective case series of 6 patients (6 eyes) diagnosed with PCV who received combination therapy with argon laser photocoagulation and ranibizumab and have at least 12 months follow-up. Argon laser photocoagulation was applied directly to the polypoidal lesions as identified on indocyanine green angiography and followed by a course of intravitreal ranibizumab injections. The primary outcome measures were the mean change in logMAR visual acuity and the mean change in central macular thickness (CMT) at final follow-up.
Results.
The mean (SD) duration of follow-up was 1.09 (0.22) years. At the final follow-up the difference (95% confidence interval [CI]) in logMAR acuity was 0.48 (0.10-0.74) (p=0.01) and the difference (95% CI) in CMT was 207 μm (35-490) (p=0.02) on optical coherence tomography. The mean (SD) number of ranibizumab injections per eye was 4.83 (3.6). The mean (SD) number of laser treatments per eye was 1.16 (0.4).
Conclusions.
In this study, combination therapy with focal argon laser photocoagulation and intravitreal ranibizumab resulted in improved visual acuity and clinical outcomes for patients with PCV for up to 1 year.
NakashizukaH., MitsumataM., OkisakaS.Clinicopathologic findings in polypoidal choroidal vasculopathy.Invest Ophthalmol Vis Sci2008; 49: 4729–37.
3.
RosaR.H.Jr, DavisJ.L., EifrigC.W.. Clinicopathologic reports, case reports, and small case series: clinicopathologic correlation of idiopathic polypoidal choroidal vasculopathy.Arch Ophthalmol2002; 120: 502–8.
4.
SatoT., KishiS., WatanabeG., MatsumotoH., MukaiR.. Tomographic features of branching vascular networks in polypoidal choroidal vasculopathy.Retina2007; 27: 589–94.
5.
TongJ.P., ChanW.M., LiuD.T.Aqueous humor levels of vascular endothelial growth factor and pigment epithelium-derived factor in polypoidal choroidal vasculopathy and choroidal neovascularization.Am J Ophthalmol2006; 141: 456–62.
6.
MatsuokaM., OgataN., OtsujiT., NishimuraT., TakahashiK., MatsumuraM.. Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathy.Br J Ophthalmol2004; 88: 809–15.
7.
GhajarniaM., KurupS., EllerA.. The therapeutic effects of intravitreal bevacizumab in a patient with recalcitrant idiopathic polypoidal choroidal vasculopathy.Semin Ophthalmol2007; 22: 127–31.
8.
TomitaK., TsujikawaA., YamashiroK.Treatment of polypoidal choroidal vasculopathy with photodynamic therapy combined with intravitreal injections of ranibizumab.Am J Ophthalmol2012; 153: 68–80.
AkazaE., YuzawaM., MatsumotoY., KashiwakuraS., FujitaK., MoriR.. Role of photodynamic therapy in polypoidal choroidal vasculopathy.Jpn J Ophthalmol2007; 51: 270–7.
16.
AkazaE., MoriR., YuzawaM.. Long-term results of photodynamic therapy of polypoidal choroidal vasculopathy.Retina2008; 28: 717–22.
17.
AkazaE., YuzawaM., MoriR.. Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy.Jpn J Ophthalmol2011; 55: 39–44.
18.
ByeonS.H., LewY.J., LeeS.C., KwonO.W.. Clinical features and follow-up results of pulsating polypoidal choroidal vasculopathy treated with photodynamic therapy.Acta Ophthalmol2010; 88: 660–8.
19.
ChanW.M., LamD.S., LaiT.Y.Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy: one-year results of a prospective case series.Ophthalmology2004; 111: 1576–84.
20.
Reche-FrutosJ., Calvo-GonzalezC., Donate-LopezJ., Garcia-FeijooJ., LeilaM., Garcia-SanchezJ.. Short-term anatomic effect of ranibizumab for polypoidal choroidal vasculopathy.Eur J Ophthalmol2008; 18: 645–8.
21.
EandiC.M., OberM.D., FreundK.B., SlakterJ.S., YannuzziL.A.. Selective photodynamic therapy for neovascular age-related macular degeneration with polypoidal choroidal neovascularization.Retina2007; 27: 825–31.
22.
KurashigeY., OtaniA., SasaharaM.Two-year results of photodynamic therapy for polypoidal choroidal vasculopathy.Am J Ophthalmol2008; 146: 513–9.
23.
OtaniA., SasaharaM., YodoiY.Indocyanine green angiography: guided photodynamic therapy for polypoidal choroidal vasculopathy.Am J Ophthalmol2007; 144: 7–14.
24.
LealS., SilvaR., FigueiraJ.Photodynamic therapy with verteporfin in polypoidal choroidal vasculopathy: results after 3 years of follow-up.Retina2010; 30: 1197–205.
25.
HiramiY., TsujikawaA., OtaniA.Hemorrhagic complications after photodynamic therapy for polypoidal choroidal vasculopathy.Retina2007; 27: 335–41.
26.
ImaiH., HondaS., NakanishiY., YamamotoH., TsukaharaY., NegiA.. Different transitions of multifocal electroretinogram recordings between patients with age-related macular degeneration and polypoidal choroidal vasculopathy after photodynamic therapy.Br J Ophthalmol2006; 90: 1524–30.
27.
RuamviboonsukP., TadaratiM., VanichvaranontS., HanutsahaP., PokawattanaN.. Photodynamic therapy combined with ranibizumab for polypoidal choroidal vasculopathy: results of a 1-year preliminary study.Br J Ophthalmol2010; 94: 1045–51.
28.
LaiT.Y., LeeG.K., LukF.O., LamD.S.. Intravitreal ranibizumab with or without photodynamic therapy for the treatment of symptomatic polypoidal choroidal vasculopathy.Retina2011; 31: 1581–8.
29.
KimS.J., YuH.G.. Efficacy of combined photodynamic therapy and intravitreal bevacizumab injection versus photodynamic therapy alone in polypoidal choroidal vasculopathy.Retina2011; 31: 1827–34.
30.
LeeY.H., LeeE.K., ShinK.S., LeeK.M., KimJ.Y.. Intravitreal ranibizumab combined with verteporfin photodynamic therapy for treating polypoidal choroidal vasculopathy.Retina2011; 31: 1287–93.
