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5 year results of combined treatment for polypoidal choroidal vasculopathy- verteporfin PDT and intravitreal anti-VEGF

Session Details

Session Title: AMD II

Session Date/Time: Friday 12/09/2014 | 08:00-10:00

Paper Time: 09:12

Venue: Boulevard D

First Author: : H.W.Kwak SOUTH KOREA

Co Author(s): :    S.Y. Yu              

Abstract Details

Purpose:

To evaluate the 5-year efficacy of photodynamic therapy (PDT) combined with intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) in patients with polypoidal choroidal vasculopathy (PCV)

Setting:

The study was carried out in Kyung Hee University Hospital, Seoul, Korea.

Methods:

Twenty-seven eyes of 43 patients with symptomatic PCV in treatment naïve eyes followed up for ≥60 months after PDT and anti-VEGF combination therapy were retrospectively reviewed. The patients received intravitreal anti-VEGF (1.25 mg bevacizumab or 0.5 mg ranibizumab) within 7 days after PDT. All clinical data, including baseline characteristics; imaging data from fluorescein angiography, indocyanine green angiography, and optical coherence tomography; presence of recurrence; and best-corrected visual acuity (BCVA) were investigated.

Results:

The mean baseline BCVA was 0.63±0.44 logMAR, 0.36±0.29 logMAR at 12 months (p=0.001 vs. baseline) and 0.61±0.49 at 60 months (p=0.848). On the final evaluation at 60 months, the mean BCVA was improved in 16 eyes (37.2%), stable in 11 eyes (25.6%), and decreased in 16 eyes (37.2%). Mean BCVA was significantly improved up to 12 months and then improvement slowly decreased over 60 months. Significant improvement maintained until 36 months (p=0.05). The mean CFT was 344.3 ± 114.8 at baseline and significantly decreased to 229.3 ± 60.9 at 12 months and the final CFT at 60 months was 231.3 ± 63.4. PDT was administered 1.79 ± 1.28 times and anti-VEGF injected 8.28±6.89 times over the 60-month period. Multiple regression analysis showed old age (p = 0.021), large PDT size (p = 0.006) were significantly negatively associated with BCVA change at final visit

Conclusions:

Significant visual improvement by combined PDT and anti-VEGF injection was maintained up to the third year of initial treatment; however, utmost improvement decreased after the first year. After 60 months, 62.8 % of PCV patients showed stable or improved BCVA. The old age and large PDT size were significantly associated with long-term visual outcome.

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