1-year results of combined half-dose photodynamic therapy and ranibizumab for polypoidal choroidal vasculopathy.

Abstract

BACKGROUND:

To evaluate the efficacy and safety of half-dose photodynamic therapy (PDT combined with ranibizumab for polypoidal choroidal vasculopathy (PCV). PCV is commonly treated with a combination of anti-vascular endothelial growth factor and standard-dose photodynamic therapy (PDT). Choroidal ischemia and visual loss can be resulted from the standard-dose PDT. Half-dose PDT has proved to produce similar results and safety profile in treating central serous chorioretinopathy. Half-dose PDT may offer an alternative for PCV cases where the damage to choroidal vasculature maybe less. Here, we report the efficacy of treating PCV cases with combination of ranibizumab and half-dose PDT.

METHODS:

In this prospective, non-comparative, interventional case series, 19 treatment-naive eyes were treated with combined half-dose PDT and ranibizumab. All subjects were followed up for 12 months with measurement of best-corrected visual acuity (BCVA), central foveal thickness (CFT) by optical coherence tomography. Indocyanine green angiogram (ICG) was performed every 3-monthly, and subjects assessed in terms of polyp regression rates, changes in vision and central foveal thickness, need to repeat half-dose PDT. Subgroup analysis was performed based on ICG features.

RESULTS:

The mean logMAR BCVA improved from 0.64 at baseline to 0.41 at 12 months. The mean CFT improved from 459.6 mum at baseline to 384.2 mum at 12 months. The difference between baseline BCVA and CFT and that at 12 months were statistically significant (both P = 0.03). Polyp regression rate after one half-dose PDT was 42.1 %. This was 61.5 % in the polyp-only group, while that in the branching-vascular-network (BVN) group was 0 % (P = < 0.01).

CONCLUSION:

Half-dose PDT combined with intravitreal ranibizumab was able to induce high polyp regression rate in PCV cases that had one single polyp.

• Authors: Ian Y Wong, Xuan Shi, Rita Gangwani, Paul Zhao, Lawrence P Iu, Qing Li, Alex Ng, Xiaoxin Li
• Journal: BMC ophthalmology (BMC Ophthalmol) Vol. 15 Pg. 66 (Jun 30 2015) ISSN: 1471-2415 [Electronic] England
• PMID: 26122636 (Publication Type: Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Photosensitizing Agents
• Porphyrins
• VEGFA protein, human
• Vascular Endothelial Growth Factor A
• Verteporfin
• Ranibizumab

Topics

• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (therapeutic use)
• Choroid (blood supply)
• Choroid Diseases (diagnosis, drug therapy, physiopathology)
• Combined Modality Therapy
• Female
• Fluorescein Angiography
• Humans
• Intravitreal Injections
• Male
• Middle Aged
• Photochemotherapy
• Photosensitizing Agents (administration & dosage)
• Polyps (diagnosis, drug therapy, physiopathology)
• Porphyrins (administration & dosage)
• Prospective Studies
• Ranibizumab (therapeutic use)
• Treatment Outcome
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Verteporfin
• Visual Acuity (physiology)