Two-year follow-up of ranibizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy

Abstract

PurposeWe evaluated the 2-year efficacy of combined intravitreal ranibizumab (IVR) treatment and photodynamic therapy (PDT) for treatment-naïve polypoidal choroidal vasculopathy (PCV).Patients and methodsTwenty-two eyes of 22 Japanese patients with treatment-naïve PCV were prospectively recruited. All eyes had angiographic features of PCV according to indocyanine green angiography. The initial combination treatment regimen included a session of PDT with IVR. A total of three consecutive IVR treatments were given at 4-week intervals. Eyes were retreated with IVR or PDT at specific times. We evaluated the mean visual acuity and mean central retinal thickness (CRT) at 3, 6, 9, 12, 18, and 24 months after initial treatment.ResultsAt month 9, visual acuity had improved by 5.7 letters (P = 0.10). Subsequently, mean visual acuity gradually decreased, and the difference from baseline was diminished to 2.9 letters at 24 months (P = 0.43). Mean CRT was significantly decreased from baseline over the 24-month follow-up (P < 0.05).ConclusionWith PDT combined with IVR for PCV, visual acuity improved during year 1, but the benefit decreased in year 2.

Polypoidal choroidal vasculopathy: a comprehensive clinical update

“…The visual gain diminishes after 6 months to 1 year and the final visual acuity at 2 years is not statistically different from the baseline. 141–143 It is possible that if PDT is applied days after the anti-VEGF injection (half-life of the drug), the collegial benefit of the combined treatment may be limited.…”

Two-Year Outcome after Combination Therapy for Polypoidal Choroidal Vasculopathy: Comparison with Photodynamic Monotherapy and Anti-Vascular Endothelial Growth Factor Monotherapy

“…Two studies reported similar results, i.e. that visual acuity significantly improved during the first year of treatment, but that the benefit decreased during the second year [32,33]. A recent study compared 2-year visual outcomes between PDT alone and combination therapy [24].…”