Factors Predictive of Visual Acuity Outcomes 1 Year After Photodynamic Therapy in Japanese Patients With Polypoidal Choroidal Vasculopathy

Hikichi, Taiichi; Ohtsuka, Hideo; Higuchi, Makoto; Matsushita, Takuro; Ariga, Hiroko; Kosaka, Shoko; Matsushita, Reiko; Takami, Kimitaka

doi:10.1097/iae.0b013e3181fecda9

Cited by 24 publications

(16 citation statements)

References 36 publications

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“…However, it should be taken into account that type 1 PCV had a larger GLD than type 2 PCV at baseline. Since previous reports demonstrated that smaller lesions were more susceptible to PDT [10,23,24], differences in the mean lesion size between type 1 PCV group and type 2 PCV group might influence in part the outcome of PDT in the present study. However, the good response to PDT in type 2 PCV remained significant after matching the lesion size with that of type 1 PCV, which confirmed the higher susceptibility of type 2 PCV to PDT compared to type 1 PCV.…”

Section: Discussionmentioning

confidence: 84%

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

Honda

Miki²,

Yanagisawa³

et al. 2014

Ophthalmologica

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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.

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Section: Discussionmentioning

confidence: 84%

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

Honda

Miki²,

Yanagisawa³

et al. 2014

Ophthalmologica

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“…PDT combined with anti-VEGF therapy is currently recommended for treatment of PCV and was reported to have good visual outcome in patients suffering from PCV. [22][23][24][25] However, relatively few studies have investigated the visual prognostic factors following PCV treatments, [26][27][28][29][30] especially the predictive factors following combined therapy. Some of the clinical factors such as age, baseline best-corrected visual acuity and size of haemorrhage, and presence of PED were reported to govern the final visual outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Some of the clinical factors such as age, baseline best-corrected visual acuity and size of haemorrhage, and presence of PED were reported to govern the final visual outcome. 26 Recently, the baseline polyp size and the location of polyps were also proven to affect the long-term visual acuity in a retrospective cohort. 31 However, these results were rather inconsistent.…”

Section: Discussionmentioning

confidence: 99%

Outcome of polypoidal choroidal vasculopathy at 1 year by combined therapy of photodynamic therapy with ranibizumab and predictive factors governing the outcome

Young

et al. 2014

Eye

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Aim To report the visual outcome of polypoidal choroidal vasculopathy receiving combined treatment with photodynamic therapy using Visudyne and intravitreal ranibizumab injections, and to analyze the predictive factors of visual outcome at 1 year post treatment. Methods Seventy-four consecutive patients with newly diagnosed polypoidal choroidal vasculopathy were treated with photodynamic therapy using Visudyne and three loading doses of intravitreal ranibizumab. The final visual outcome and polyp eradication rate at 1 year were reported. A stepwise regression model was used to estimate the baseline clinical factors predictive of better visual outcome and polyp eradication.Results Visual acuities at 12-months followup improved significantly compared with baseline from 0.828 logMAR to 0.728 logMAR (P ¼ 0.026). The mean foveal thickness decreased from 380±175 to 278±117 mm. In all 29.7% of eyes improved at least by 0.3 logMAR, and 55.4% remained stable in visual acuity with less than 0.3 logMAR change. Overall, 85% of eyes achieved at least stable vision, 20.2% (15/74) cases achieved polyp eradication on angiogram, and 60.8% (45/74) achieved polyp size reduction on angiogram at 1 year. Regarding predictive factors, the baseline visual acuity (P ¼ 0.003), no foveal involvement by abnormal choroidal vasculature (Po0.0001), absence of hard exudates (0.001) or subretinal fluid (o0.0001) are important clinical factors affecting the final visual outcome. Conclusions Combination therapy with photodynamic therapy using Visudyne and three loading doses of intravitreal ranibizumab injections resulted in 85% success rate on visual stabilization and 81% success rate in polypoidal lesion control.

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“…In view of the angiographic subtypes of PCV, type 1 PCV is considered to be more refractory to PDT than type 2 PCV [60]. Although the mean VA was improved and maintained up to 12 months after PDT in most reports [14,15,112,113,114,115,116,117,118,119], longer observational studies revealed that the merit of therapy was reduced 12 months after the initial PDT, mainly due to recurrences of the lesions [14,120,121,122]. Consequently, the improvement in the mean VA of the PCV patients was not significant anymore 30-36 months after the initial PDT [14,121,122].…”

Section: Response To Treatmentmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy: Clinical Features and Genetic Predisposition

2013

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Polypoidal choroidal vasculopathy (PCV) is currently recognized as a phenotype of age-related macular degeneration (AMD). PCV is believed to be a type of choroidal neovascularization, although some cases of PCV show a distinct vascular abnormality of the choroidal vessels. PCV often shows several unique clinical manifestations which are apparently different from typical neovascular AMD (tAMD). In addition, the natural course and response to treatment are often different between tAMD and PCV. Moreover, recent genetic studies suggested a possible difference in the genetic susceptibility to disease between tAMD and PCV, as well as the existence of heterogeneity among PCV cases. In viewing the accumulation of knowledge about PCV, we have summarized the recent literature regarding PCV in this review article to improve the understanding of this clinical entity including possible susceptibility genes. We will also discuss the optimal treatment strategies for PCV in accordance with the results of recent clinical and genetic studies.

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Factors Predictive of Visual Acuity Outcomes 1 Year After Photodynamic Therapy in Japanese Patients With Polypoidal Choroidal Vasculopathy

Abstract: Photodynamic therapy stabilized eyes anatomically and functionally. Clinical characteristics at baseline were predictors of favorable VA outcomes after PDT. These findings may help establish the strategy of treatment for polypoidal choroidal vasculopathy.

Cited by 24 publications

References 36 publications

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

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

Outcome of polypoidal choroidal vasculopathy at 1 year by combined therapy of photodynamic therapy with ranibizumab and predictive factors governing the outcome

Polypoidal Choroidal Vasculopathy: Clinical Features and Genetic Predisposition

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