Two-Year Results of Reduced-Fluence Photodynamic Therapy for Polypoidal Choroidal Vasculopathy

Abstract

To report the results of a 2-year follow-up study of Japanese polypoidal choroidal vasculopathy (PCV) patients treated with reduced-fluence photodynamic therapy (PDT) monotherapy. Prospective interventional case series. In the present study, 38 eyes of 38 consecutive patients underwent PDT with a reduced laser fluence of 25 J/cm(2). During the 2-year follow-up, visual acuity (VA) and optical coherence tomography measurements were performed every 3 months after the PDT procedure and then compared with baseline values. PCV vascular lesions were evaluated by indocyanine green and fluorescein angiography. At baseline, the mean logarithm of the minimal angle of resolution (logMAR) best-corrected VA (BCVA) was 0.43. There was a significant improvement of the mean logMAR BCVA to 0.28 and 0.29 at 12 and 24 months, respectively (P < .0001, P = .001). The logMAR BCVA was stable or improved by ≥0.3 in 36 (95%) of the eyes at the 2-year follow-up. In 13 eyes in which the baseline VA was better than 20/40, there was a significant improvement of the mean logMAR BCVA at 12 months, with the acuities continuing to be stable at 24 months. The mean number of treatment sessions during the 24-month study period was 1.9. Reduced-fluence PDT monotherapy for PCV effectively improved and maintained the VA over a 24-month period, even in eyes with a baseline VA better than 20/40. In addition, the number of treatments could be much smaller as compared with intravitreal injection of anti-vascular endothelial growth factor agents.