Early changes of vascular lesions and responses to combined photodynamic therapy in patients with polypoidal choroidal vasculopathy.

Abstract

To evaluate early changes of vascular lesions and their associations with the early responses to combined photodynamic therapy (PDT) in eyes with polypoidal choroidal vasculopathy (PCV). This study evaluated 19 eyes of 19 patients with PCV who underwent PDT combined with anti-vascular endothelial growth factor injections and were followed for 3months. All subjects were examined 1week and 1, 2, and 3months after combined PDT. "Active" cases were defined as recurrence or persistence of serous retinal detachment or subretinal hemorrhage detected within 3months. Branching vascular networks (BVNs) were evaluated by optical coherence tomography angiography (OCTA) and polyps by indocyanine-green angiography. In total, 16%, 58%, 84%, and 89% of eyes displayed BVNs 1week, 1, 2, and 3months after PDT, respectively. BVNs were detected significantly more often 1month after PDT in the "active" group than "inactive" group (89% vs. 30%, p = 0.020). There were significantly higher overall proportions of BVNs detected by OCTA in the "active" group than "inactive" group (p = 0.0058). In most cases, BVNs disappeared once and gradually appeared again within 3months. Detecting BVNs using OCTA from early phases could be a helpful biomarker to assess the early responses to PDT in eyes with PCV.