Visual Parameters and Retinal Morphology for Polypoidal Choroidal Vasculopathy Pre- and Post-Intravitreal Ranibizumab with or without Photodynamic Therapy: A Short-Term Prospective Study.

Rituparna Ghoshal,Sharanjeet Sharanjeet-Kaur,Somnath Ghosh,Nor Fariza Ngah,Roslin Azni Binti Abd Aziz,Norliza Mohamad Fadzil

doi:10.3390/ijerph18052581

Abstract

The objective of this study was to compare visual parameters and retinal layers’ morphology pre-treatment (baseline) and 6 months post-treatment in polypoidal choroidal vasculopathy (PCV) eyes. A single centre, longitudinal, prospective study was conducted at a public tertiary hospital of Malaysia. Visual parameters including distance and near visual acuity (DVA and NVA), contrast sensitivity (CS), reading speed (RS), and different qualitative and quantitative optical coherence tomography (OCT) parameters were evaluated pre- and 6 months post-treatment. Thirty-three naïve PCV eyes of 32 patients (mean age of 67.62 years) were evaluated pre- and post-treatment of intravitreal ranibizumab with and without photodynamic therapy. After treatment, sub retinal fluid decreased from 27 eyes (84.35%) at baseline to 7 eyes (21.88%) at 6 months while pigment epithelium detachment decreased from 32 eyes (100%) at base line to 15 eyes (46.87%) at 6 months. Mean pre-treatment quantitative morphological OCT retinal parameters including thickness and volume of central sub field, center thickness, center minimum, and maximum thickness reduced significantly. Similarly, all visual parameters including DVA, NVA, CS, and RS showed statistically significant improvement. While 89% of the eyes showed improvement in CS, 78%, 71%, and 65% of the eyes showed improvement in NVA, RS, and DVA, respectively. Thus, CS was the most treatment responsive visual parameter.

Highlights

Polypoidal choroidal vasculopathy (PCV) is a commonly seen subtype of Asian neovascular age-related macular degeneration (n-AMD) [1,2,3,4,5,6]
The rest of the six eyes underwent anti-VEGF monotherapy with ranibizumab
optical coherence tomography (OCT) parameters used in the present study showed significant improvement (p < 0.05)

Summary

Introduction

Polypoidal choroidal vasculopathy (PCV) is a commonly seen subtype of Asian neovascular age-related macular degeneration (n-AMD) [1,2,3,4,5,6]. Clinical features of PCV eyes have been described in previous studies [7,8,9]. Many of the clinical trials reported a combined therapy of intravitreal antivascular endothelial growth factor (anti-VEGF) injection and photodynamic therapy (PDT). As the most promising treatment option, followed by PDT monotherapy and anti-VEGF monotherapy [11,12,13,14,15]. A recent study from an AMD referral centre of Malaysia showed a similar approach in treating PCV with combined therapy being the most frequently used treatment approach [16].

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Discussion

Conclusion