Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy

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Objective To evaluate the 3-year efficacy of photodynamic therapy (PDT) in patients with polypoidal choroidal vasculopathy (PCV).Methods This is a retrospective,uncontrolled case series study.Thirty-two eyes of 29 patients with PCV were enrolled.All patients were primarily treated with the first conventional PDT.For the eye with active polypoida,residual or exudative lesions in 6 month after PDT,PDT combined with intravitreal anti vascular endothelial growth factor (VEGF)or simple vitreous injection of anti VEGF therapy were used.All the patients were followed up for at least 3 years with the mean follow-up duration of 43.64±10.84 months.The best-corrected visual acuity (BCVA) in 1,3,6,12,24 and 36 months after the primary PDT,PCV recurrence rates and number of treatments were followed and analyzed.The BCVA was converted into a logarithm of the minimal angle of resolution (logMAR) for statistical analysis.Results During the 1,3,6,12 months after the primary PDT,the mean BCVA were all improved with statistically significant difference (t =2.27,4.57,3.77,2.37; P ＜ 0.05).During the 24 and 36 months after PDT,the mean BCVA was decreased without statistically significant difference(t =-1.29,-0.81; P＞0.05).On the final evaluation at 36 months,the mean BCVA was improved in 6 eyes (18.75％),stable in 14 eyes(43.75％),and decreased in 12 eyes(37.50％).During the follow-up time,recurrence of PCV in 24 eyes (75.00％),no recurrence in 8 eyes (25.00％).There was 1 recurrence in 12 eyes (50.00％),2 recurrences in 9 eyes (37.50％),3 recurrences in 3 eyes (12.50％).Initial recurrences were noted in 4 eyes (16.67％) within 12 months of baseline PDT treatment; in 11 eyes (45.83％) between 13 and 24 months; in 9 eyes (37.50％) between 25 and 36 months.The mean number of PDT and anti-VEGF was 1.86±1.04 and 4.95±3.92 in all patients,respectively.Conclusion The 3-year efficacy of PDT in patients with PCV was poor with low improvement of visual acuity and high recurrence rate of PCV. Key words: Choroid diseases/therapy; Photochemotherapy; Antibodies,monoclonal/therapeutic use