Adjunctive photodynamic therapy for type 1 choroidal neovascularization associated with thickened choroid

Abstract

PurposeTo evaluate the treatment outcomes of adjunctive photodynamic therapy (PDT) in patients with type 1 choroidal neovascularization (CNV) associated with thickened choroid and refractory to anti‐vascular endothelial growth factor (VEGF) monotherapy.MethodsData on 28 eyes of 28 patients with type 1 CNV with a minimum subfoveal choroidal thickness of 300 μm were reviewed. All showed persistent subretinal and/or intraretinal fluid after at least 4 anti‐VEGF injections in the 6 months before adjunctive PDT. No eyes had certain polypoidal lesions on indocyanine green angiography. The main outcomes measured included the rates of complete fluid absorption at 3 months and the change in best‐corrected visual acuity (BCVA) at 12 months.ResultsAt 3 months, complete fluid absorption was observed in 24 eyes (85.7%). The mean central macular thickness significantly reduced from 342 ± 63 μm to 242 ± 60 μm, and the mean subfoveal choroidal thickness from 386 ± 80 μm to 350 ± 91 μm compared to baseline (P < 0.001, P < 0.001, respectively). Over the 1‐year follow‐up period, 17 eyes (60.7%) were free from recurrent fluid accumulation. Anti‐VEGF injection was mainly used in the re‐treatment of persistent or recurrent exudation (mean: 1.5). At 12 months, the mean BCVA significantly improved compared to baseline (20/53 to 20/44, P = .039), and the logarithm of the minimal angle of resolution BCVA improved by ≥0.3 or maintained in 27 eyes (96.4%).ConclusionsAdjunctive PDT in eyes with type 1 CNV with thickened choroid refractory to anti‐VEGF monotherapy resulted in complete fluid absorption in most eyes, which translated to visual improvement up to 1 year.