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

Abstract

Purpose: To compare treatment outcomes of photodynamic therapy (PDT), anti-vascular endothelial growth factor (VEGF) therapy and PDT combined with anti-VEGF therapy for polypoidal choroidal vasculopathy (PCV). Procedures: A total of 62 eyes of 62 patients who had completed at least 2 years of follow-up were retrospectively reviewed; 19 eyes received PDT only, 23 had anti-VEGF therapy only and 20 underwent combination therapy. Best-corrected visual acuity at baseline and each follow-up visit was investigated as a primary outcome measure. Results: At year 2, the PDT and combination groups maintained significant visual improvement (p = 0.041 and p = 0.021), whereas the anti-VEGF group failed to do so (p = 0.673) when compared with the baseline. The combination group showed better visual outcome during follow-up, and significantly better visual outcome than the PDT group (p = 0.038) and the anti-VEGF group (p = 0.012) at year 2. Conclusions: Combination therapy leads to significantly better visual outcome than PDT and anti-VEGF monotherapy and is therefore a superior method for treating PCV, with a favorable visual outcome.

Six-year outcomes of antivascular endothelial growth factor monotherapy for polypoidal choroidal vasculopathy

“…Treatment of PCV is complex and based on visual acuity (VA), location of the PCV complex and treatment response. Various treatment options for PCV exist, including photodynamic therapy (PDT) (Visudyne, verteporfin, Bausch & Lomb, Rochester, New York, USA),5–7 anti-VEGF (vascular endothelial growth factor) therapy8 9 and combination therapy 10. The EVEREST clinical trial11 was a landmark prospective study of PCV treatment that compared PDT alone, anti-VEGF therapy alone and PDT in combination with anti-VEGF therapy.…”

Polypoidal choroidal vasculopathy treatment options: A meta‐analysis

“…Among them, two articles were excluded as case reports, and two articles were excluded because they included additional treatment strategies for PCV. A final total of 22 studies were included in the present meta‐analysis. The study selection process is shown in Figure .…”

“…The mean age of patients across all studies ranged from 53 to 75.8 years, while study duration ranged from 1 to 36 months. Among the included studies were three RCTs and 19 retrospective comparative studies . Specific interventions and pro re nata (PRN) retreatment regimen used within each trial are listed in Table .…”

“…Specifically, the direct effect of PDT on polypoidal lesions, as confirmed via ICGA, and the subsequent resolution of exudative fluid can likely lead to a favourable visual outcome . Some studies have reported that PDT was superior to anti‐VEGF therapy in terms of polyp regression . As for intravitreal anti‐VEGF injections, the rapid resolution of exudative fluid and retinal oedema can play an important role in ensuring favourable BCVA outcomes …”

“…Among the included studies were three RCTs 16-18 and 19 retrospective comparative studies. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Specific interventions and pro re nata (PRN) retreatment regimen used within each trial are listed in Table 1. All retrospective studies had received scores of at least seven stars and were considered to be of high quality.…”