Polypoidal Choroidal Vasculopathy after Stereotactic Radiotherapy for Neovascular Age-Related Macular Degeneration: A Case Report with Long-Term Follow-Up

Abstract

Several adjunct therapies to the gold standard anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections have been discussed for the treatment of neovascular age-related macular degeneration (nAMD). Low-dose stereotactic radiotherapy (SRT) showed the potential to lower the treatment burden by reducing the anti-VEGF treatment frequency at least over 2–3 years but was associated with retinal microvascular abnormalities in a few cases. We report a 6-year follow-up of a case with bilateral nAMD under anti-VEGF treatment which developed multiple polypoid choroidal vasculopathy (PCV) lesions in the eye adjunct treated with low-dose SRT. The fellow eye suffering from nAMD for the same period of time but never been treated with SRT did not show PCV during the long-term follow-up. We hope to increase the awareness of possible choroidal changes such as PCV in similar patients by sharing this report.

Persistent and Poor-Responsive Cystoid Macular Edema after Stereotactic Radiotherapy in Neovascular Age-Related Macular Degeneration: A Case Report of Three Patients

“…Beside the known types of microvascular abnormalities further vascular changes like polypoidal choroidal vasculopathy 8 and sub foveal choroidal thickness thinning secondary to SRT have been described 9 . This is the first report, describing three cases with additional long-term massive cystoid edema unresponsive to anti-VEGF therapy after SRT.…”