Focal laser photocoagulation treatment in polypoidal choroidal vasculopathy: Long‐term follow‐up

Abstract

AbstractPurpose: To report the long‐term effect and safety of focal laser photocoagulation treatment (FLPT), in a case of polypoidal choroidal vasculopathy (PCV).Methods: We reviewed a 56‐month follow‐up (April 2017–January 2022) of a 54‐year‐old woman with PCV. The diagnosis was made using indocyanine green angiography (ICG‐A). The measured outcomes of the effect of FLPT were changes in best‐corrected visual acuity (BCVA), complications, regression, and recurrence of polypoidal lesions based on fundoscopy, B‐scan swept source optical coherence tomography (SS‐OCT) and ICG‐A.Results: At the time of diagnosis, the patient had extensive subretinal exudation and haemorrhage in the right eye (RE) related to foveal and juxtapapillary polypoidal lesions. She received 12 bevacizumab intravitreal injections and treatment was interrupted because of extensive macular fibrosis. In the left eye (LE), she had extrafoveal polypoidal lesions with a BCVA of 20/25. At 8 months follow‐up, a decrease in BCVA to 20/50 was noted. Therefore, a first round of FLPT associated with three bevacizumab intravitreal injections, was performed. Four months post‐FLPT, regression of the polypoidal lesions was obtained with a BCVA of 20/25. BCVA and multimodal imaging remained stable for 2 years. The left eye showed recurrence of extrafoveal polypoidal lesions 35 months after FLPT, with a BCVA of 20/50. A second round of FLPT was performed, with a regression of the polypoidal lesions after 1 month, and a stabilization of BCVA at 20/30. After 14 months, BCVA was 20/50, and no signs of recurrence were detected on multimodal imaging. No complications were observed after the two rounds of FLPT.Conclusions: FLPT can be efficient and safe in treating eyes with PCV with extrafoveal polypoidal lesions. In this case, it allowed us to obtain the regression of polypoidal lesions and to maintain visual acuity without serious hemorrhagic complications during the 56‐month follow‐up.