Effects of personalized clinical therapy for polypoidal choroidal vasculopathy

Abstract

Objective To observe the effects of personalized clinical therapy for polypoidal choroidal vasculopathy (PCV).Methods Eighty-six eyes of 79 patients with PCV were enrolled in this study.There were 60 males (65 eyes) and 19 females (21 eyes).The average age was (64.48±13.15) years old.Best corrected visual acuity (BCVA),slit lamp ophthalmoscopy,fundus photography,optical coherence tomography (OCT),fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA) were measured.The average BCVA was 0.19 ± 0..20.There were three groups in this study including photodynamic therapy (PDT) group (group A,45 eyes),PDT and intravitreal ranibizumab injection group (group B,31 eyes),and PDT combined with sub-Tenon's capsule triamcinolone acetonide injection group (group C,10 eyes).Follow up begun at 1 month after the treatment.40 eyes in group A were followed up for 1 to 12 months with the average 3.27 months.28 eyes in group B were followed up for 1 to 36 months with the average 6.68 months.9 eyes in group C were followed up for 1 to 12 months with the average 5.67 months.Patients with recurrent or worsen lesions were followed by FFA or ICGA.Pre-and post-treatment BCVA and retinal thickness of the fovea were comparatively analyzed.Results All eyes (100.0 ％) in group A,20 eyes (64.52％) in group B and 9 eyes (90.00％) in group C received treatment only once.The mean BCVA at 1 month after treatment was significantly increased than the pre-treatment BCVA in all 3 groups (t=2.061,3.262,3.258; P＜0.05),but no significant difference was found between the 3 groups (t=1.345,0.683,0.168; P＞0.05).Compared to pre-treatment measures,the mean retinal thickness of the fovea was significantly decreased in group A and group B (t=2.239,4.334; P＜0.05),but not changed in group C (t=2.286,P＞0.05) at 1 month after treatment.Thirteen eyes in group A were followed by FFA and (or) ICGA,which showed that there were 3 eyes with complete closed PCV and alleviated pigment epithelial detachment (PED),4 eyes with partial closed PCV,3 eyes with stable PCV and 3 eyes with worsen PCV.Ten eyes in group B were followed by FFA and (or) ICGA,which showed that there were 3 eyes with complete closed PCV,3 eyes with partial closed PCV,4 eyes with recurrence PCV.Five eyes in group C were followed by FFA and (or) ICGA,which showed that there were 4 eyes with complete closed PCV,1 eyes with recurrence PCV.Conclusion All 3 therapy strategies can stop or reduce PCV leakage and improve the visual acuity in some degree. Key words: Choroid diseases/therapy;  Photochemotherapy;  Antibodies, monoclonal;  Triamcinolone acetonide