Photodynamic therapy with verteporfin for age-related macular degeneration or polypoidal choroidal vasculopathy: comparison of the presence of serous retinal pigment epithelial detachment

Saito, Masaaki; Iida, Tomohiro; Nagayama, Dai

doi:10.1136/bjo.2007.137075

Cited by 50 publications

(26 citation statements)

References 29 publications

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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%

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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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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“…17,18 However, PDT with verteporfin resolves the polypoidal lesions with high prevalence in PCV eyes. 9,10 However, longer follow-up studies of PDT of 2 or 3 years have reported that the VA decreased at the final visit. [24][25][26] It is well known that PDT cannot resolve the branching Figure 1 The diagram shows the retreatment criteria in the current study after month 3 (3 months after treatment).…”

Section: Discussionmentioning

confidence: 99%

“…21 The increased subretinal hemorrhages after PDT for patients with PCV is a well-known complication with incidence rates from 18 to 30%. 10,11,20 While the current study had a small number of cases, subretinal hemorrhages did not occur during 24 months. In conclusion, the current study showed that IVR injections were effective for maintaining or improving VA and the anatomic changes in patients with PCV with recurrent or residual exudation from branching vascular networks without adverse events over 24 months.…”

Section: Discussionmentioning

confidence: 99%

“…ICGA-guided PDT was chosen if the lesion comprised a large hemorrhage or a large serous PED. 10 PDT with verteporfin was administered according to the protocol of the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy Study, except for the greatest linear dimension (GLD) in cases with ICGA-guided PDT. 20 A 689-nm laser system (Carl Zeiss Meditec, Dublin, CA, USA) was used and 50 J/cm 2 energy was delivered with an 83-second exposure time.…”

Section: Methodsmentioning

confidence: 99%

“…[4][5][6][7][8] Treatment with photodynamic therapy (PDT) with verteporfin (Visudyne, Novartis Pharma AG, Basel, Switzerland) can occlude the polypoidal lesions in patients with PCV. 9,10 However, the branching vascular network can remain after PDT. 11 Retreatments with PDT have been performed in B40% of cases due to recurrent or residual exudation despite resolution of the polypoidal lesions during 2 years of follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Two-year results of intravitreal ranibizumab for polypoidal choroidal vasculopathy with recurrent or residual exudation

Saito

Iida

Kano

et al. 2013

Eye

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Aim To clarify the 2-year efficacy of ranibizumab for patients with polypoidal choroidal vasculopathy (PCV) with recurrent or residual exudation from branching vascular networks after previous photodynamic therapy (PDT). Methods We retrospectively reviewed 26 eyes of 26 Japanese patients (22 men, 4 women) in this pilot study. All eyes had PCV with complete regression of polypoidal lesions resulting from PDT detected by indocyanine green angiography (ICGA), but recurrent or residual leakage from branching vascular networks on fluorescein angiography and evidence of persistent fluid on optical coherence tomography (OCT). Three consecutive intravitreal injections of ranibizumab (0.5 mg/0.05 ml) were administered to all eyes. Results The mean logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) improved significantly from 0.55 at baseline to 0.35 at 12 months (Po0.0001) and 0.43 at 24 months (P ¼ 0.0012). The mean increases in the BCVA 12 and 24 months after baseline were 1.95 and 1.23 lines, respectively. The mean central retinal thickness significantly decreased from 295 mm at baseline to 189 mm at 12 months (Po0.0038) and 163 mm at 24 months (Po0.001). The mean numbers of intravitreal ranibizumab (IVR) injections at months 12 and 24, including the initial treatments, were 5.8 and 8.8, respectively. Five (19.2%) eyes had recurrent polypoidal lesions on ICGA at a mean of 15.7 months after baseline. At month 24, OCT showed no exudation in 17 (65.4%) of the 26 eyes. No adverse events developed.Conclusions IVR injections maintained or improved the VA and retinal thickness at 24 months in eyes with PCV with recurrent or residual exudation from branching vascular networks after previous PDT.

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Polypoidal Choroidal Vasculopathy

Maruko

Iida

2016

Spectral Domain Optical Coherence Tomography in Macular Diseases

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Photodynamic therapy with verteporfin for age-related macular degeneration or polypoidal choroidal vasculopathy: comparison of the presence of serous retinal pigment epithelial detachment

Cited by 50 publications

References 29 publications

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

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

Two-year results of intravitreal ranibizumab for polypoidal choroidal vasculopathy with recurrent or residual exudation

Polypoidal Choroidal Vasculopathy

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