Clinical Ophthalmology (Oct 2018)

Polypoidal choroidal vasculopathy (PCV): the 4-year review of the real-life treatment experiences

  • Ratanasukon M,
  • Bhurayanontachai P,
  • Jirarattanasopa P

Journal volume & issue
Vol. Volume 12
pp. 2177 – 2181

Abstract

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Mansing Ratanasukon, Patama Bhurayanontachai, Pichai Jirarattanasopa Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla Province 90110, ThailandPurpose: The purpose of this article was to study the real-life treatment results of polypoidal choroidal vasculopathy (PCV).Design: This was a retrospective study.Methods: Patients with presumed age-related macular degeneration were reviewed, and PCV diagnosis was made using the EVEREST study criteria. Outcomes were changes in visual acuity (VA) and central retinal thickness, time between treatments, follow-up time, and number of treatments.Results: The prevalence of PCV was 30.8%. At the beginning, 195 eyes received monotherapy of anti-vascular endothelial growth factor (anti-VEGF) injections, either bevacizumab or ranibizumab, and only six eyes received the combination of anti-VEGF injection and photodynamic therapy (PDT) at the time of the first treatment. During the follow-up, some patients received “rescue or add-on” PDT when they had a poor response after anti-VEGF injections. After 4 years, the average number of injections was 8.25 and 9.15 for the anti-VEGF monotherapy and the combination groups, respectively. The average time between the first anti-VEGF injections and the first PDT was 21.4 months. The average VA in the anti-VEGF monotherapy group increased by 1.5 letters, whereas it decreased by 0.95 letters in the combination group (P=0.48).Conclusion: The review demonstrated the same visual outcomes between the combination therapy of anti-VEGF injections and rescue or add-on PDT vs monotherapy anti-VEGF injections in PCV treatment. When compared with EVEREST II and Planet studies, the “initial” or “rescue or add-on PDT” might have different effects on the final visual outcomes.Keywords: polypoidal choroidal vasculopathy, anti-vascular endothelial growth factor, photodynamic therapy

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