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Photodynamic therapy for polypoidal choroidal vasculopathy.

Abstract
The first effective therapy for exudative macular degeneration (AMD) was Photodynamic Therapy (PDT). Diagnosis of the disease was to a large extent by fluorescein angiography (FA). Distinguishing between the leaky choroidal neovessels (CNV) associated with exudative AMD, and the polypoidal structures associated with Polypoidal Choroidal Vasculopathy (PCV) is not always easy using FA alone. The switch to Indocyanine Green angiography helped to pinpoint PCV, and thus to study the efficacy of photodynamic therapy of this particular form of retinal disease, which is more frequently encountered among pigmented individuals. The results appear to be quite promising, and in the year following treatment only a small fraction of the patients had to be retreated. Alternatively, treating PCV with repeated intravitreal VEGF blocking agents was not as successful as it was in the treatment of wet AMD. However, combining PDT-induced angio-occlusion of the polypoidal lesions with anti-vascular endothelial growth factor therapy was shown to be quite effective, and the combination of PDT with an anti-angiogenic agent as well as a steroid, in a triple therapy, was recently also shown to be a quite promising option. In the present article we review the data on PDT of PCV, including combination therapies and alternative treatments. We also report on similarities and differences between AMD and PCV.
AuthorsPatrycja Nowak-Sliwinska, Hubert van den Bergh, Michel Sickenberg, Adrian H C Koh
JournalProgress in retinal and eye research (Prog Retin Eye Res) Vol. 37 Pg. 182-99 (Nov 2013) ISSN: 1873-1635 [Electronic] England
PMID24140257 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
CopyrightCopyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.
Chemical References
  • Angiogenesis Inhibitors
  • Photosensitizing Agents
Topics
  • Angiogenesis Inhibitors (therapeutic use)
  • Choroid Diseases (drug therapy, pathology, radiotherapy)
  • Combined Modality Therapy (methods)
  • Drug Therapy, Combination (methods)
  • Humans
  • Low-Level Light Therapy
  • Macular Degeneration (drug therapy, pathology, radiotherapy)
  • Photochemotherapy (methods)
  • Photosensitizing Agents (therapeutic use)

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