Comparison of the Outcomes of Photodynamic Therapy between Two Angiographic Subtypes of Polypoidal Choroidal Vasculopathy

Abstract

Background: To compare the outcomes of photodynamic therapy (PDT) between two different angiographic subtypes of polypoidal choroidal vasculopathy (PCV). Methods: Ninety-three consecutive cases of PCV were classified into two phenotypes (42 type 1 and 51 type 2) according to the presence or absence of feeding vessels found on indocyanine green angiography. Full-dose PDT and retreatments were performed every 3 months as needed based on the findings on angiography. The best-corrected visual acuity (BCVA) was compared as the main outcome between type 1 and type 2 PCV up to 12 months after the initial PDT. Results: The baseline greatest linear dimension (GLD) was significantly larger in type 1 PCV than type 2 PCV. The mean BCVA was significantly improved from baseline in type 2 PCV, while no improvement was found in type 1 PCV. Analysis with matching the GLD between both PCV subtypes did not change the original results. Conclusions: There may be a significantly different response to PDT between two angiographic phenotypes of PCV.

Comparison of the 12-Month Outcomes of Intravitreal Ranibizumab between Two Angiographic Subtypes of Polypoidal Choroidal Vasculopathy

“…A recent report described better visual and anatomical outcomes of intravitreal aflibercept in type 1 PCV than type 2 PCV over 6 months of follow-up [20] . Those results were in contrast to our previous report, which demonstrated that type 2 PCV showed a better visual outcome of PDT than type 1 PCV [15] . Although the actual reasons for those results are currently unknown, a different mechanism of PDT to reduce exudative lesions is likely associated with different effects from IVR since PDT is thought to collapse polypoidal lesions by inducing embolization inside the polyps.…”

“…Those studies demonstrated that type 1 PCV usually has larger lesion sizes due to the larger and more distinct BVN, smaller polyp size on ICGA, and smaller choroidal thickness [13,14] . We recently reported that the visual outcome of photodynamic therapy (PDT) was significantly better in type 2 PCV than type 1 PCV [15] , and such difference might also exist in the response to IVR between 2 angiographic PCV subtypes. Hence, we compared the 12-month outcomes of IVR between type 1 PCV and type 2 PCV in this study.…”

Polypoidal Choroidal Vasculopathy with Feeder Vessels: Characteristics, Fellow Eye Findings, and Long-term Treatment Outcomes

“…Kawamura et al [4] suggested that efficacy of treatments may differ depending on the type of PCV. In a study by Honda et al [9], a significant visual improvement after photodynamic therapy was noted in PCV type 2, whereas the visual improvement was limited in PCV type 1. In a study by Tan et al [5], the treatment outcome was also associated with the subtype of PCV; the best treatment outcome was noted in type A, whereas the worst treatment outcome was noted in type C. These results suggest that classifying PCV is important in establishing a treatment plan and understanding the origin of the disorder.…”

“…More recently, Tan et al [5] suggested classifying PCV into three subtypes based on the characteristics of the BVNs and leakage on fluorescein angiography. The classification of PCV is important because treatment outcomes and genetic background may differ depending on the subtype of PCV [56789]. …”

Short-term efficacy of intravitreal aflibercept depending on angiographic classification of polypoidal choroidal vasculopathy

“…One comparative study reported the treatment outcomes of photodynamic therapy (PDT) between the two subtypes 7. To our knowledge, no study has reported the treatment efficacy of anti-vascular endothelial growth factor (VEGF) on the two subtypes of PCV.…”