Purpose: Indications for photodynamic therapy (PDT) have increased from age-related macular degeneration with choroidal neovascularization (CNV), containing more than 50% of the classic component, to occult CNV, myopic CNV and CNV due to ocular histoplasmosis syndrome. In the present study, the effect of PDT with verteporfin was examined in polypoidal choroidal vasculopathy (PCV) of the macula. Methods: PDT was performed in 9 eyes with PCV of the macula. Fundus examination, fluorescein angiography, and indocyanine green angiography were performed before PDT and 3 months after PDT in all eyes. Optical coherence tomography was performed in 6 eyes. Results: After the initial PDT, visual acuity was stabilized or improved in 8 eyes (89%), polypoid elements were obliterated in 7 eyes (78%), and vascular nets were reduced in 8 eyes (89%). Of 6 eyes that received optical coherence tomography, pigment epithelium detachment was reduced or disappeared in all eyes except 1, which developed a disciform scar. An additional PDT was performed in 4 eyes to decrease vascular leakage. During the follow-up period of 3–18 months, no reactivation of PCV was observed. Conclusion: PDT offers an effective way of treating PCV of the macula, by obliterating polypoid elements of the PCV. However, long-term follow-up is needed.

The classification, size and activity of choroidal neovascularization (CNV) by optical coherence tomography (OCT) were compared with those obtained by fluorescein angiography (FA) and Indocyanine green angiography (ICG). This study included 32 patients (32 eyes) diagnosed as having CNV. The etiology of CNV was found to be age-related macular degeneration (AMD) or non-AMD. Patients were studied retrospectively by FA, ICG, and OCT. Of the 13 eyes with AMD, the boundary of the lesion could not be defined using FA in 7 patients. Among the 7 poorly defined CNV cases by FA, the identification of the boundary was possible in one case by OCT. The mean diameter of the classic well-defined lesions was 3500 +/- 421 microm by FA, 2624 +/- 1044 microm by ICG, and 1927 +/- 1272 microm by OCT. The size of the CNV by OCT was always smaller than by FA or ICG. Of the 19 eyes with Non-AMD, the boundary of the lesion could not be defined by FA in 5 patients. Among the 5 poorly defined cases by FA, the identification of the boundary was possible in 3 cases by OCT. The mean diameter of the well-defined CNV lesions was 2153 +/- 759 microm by FA, 1929 +/- 673 microm by ICG, and 1322 +/- 566 microm by OCT. Retinal thickness, which represents retinal edema, was found to be proportional to lesion size, although the relationship was not statistically significant. Regardless of CNV type, FA, ICG and OCT used in combination increase the specificity of diagnosis if their findings are compared.