Extensive submacular haemorrhage in polypoidal choroidal vasculopathy managed by sequential gas displacement and photodynamic therapy: a pilot study of one-year follow up.
BACKGROUND
Polypoidal choroidal vasculopathy (PCV) with peculiar vascular lesions presents frequently as recurrent submacular haemorrhage. The best treatment is still not certain. It is the authors' objective to evaluate the 1-year safety and efficacy of photodynamic therapy (PDT) using verteporfin for persistent macular PCV after pneumatic displacement of the massive submacular haemorrhage with intravitreal perfluoropropane (C(3)F(8)).


METHODS
A prospective, non-comparative, interventional case series on patients with extensive and thick submacular haemorrhage secondary to PCV, which was displaced pneumatically with intravitreal pure 0.4 ml C(3)F(8). Fluorescein angiography and indocyanine green angiography were repeated 1-2 weeks later to delineate any persistent active leaking polypoidal lesions, which were then treated with PDT. Retreatment might be considered in each follow up at every 3 months.


RESULTS
Six eyes of six patients with the mean age of 53.6 years had been recruited and completed 1-year follow up. The mean baseline Snellen equivalent best-corrected visual acuity (BCVA) was 6/92 and the mean final BCVA at 1 year was 6/17. The mean improvement in logMAR BCVA after the sequential treatments was seven lines (range +3 to +19 lines) (Wilcoxon signed-ranks test, P = 0.03). All patients had at least moderate visual gains. No patient suffered serious complications from PDT.


CONCLUSIONS
This first report on combined treatment with intravitreal gas injection and sequential PDT on PCV seems to be a well-tolerated option. Further comparative studies with larger sample size and longer follow up are warranted.
Chan
Wai-Man
WM
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China. cwm6373@netvigator.com
Liu
David T L
DT
Lai
Timothy Y Y
TY
Li
Haitao
H
Tong
Jian-Ping
JP
Lam
Dennis S C
DS
D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography; D005466:Fluorocarbons / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D007267:Injections; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D010865:Pilot Projects; D011166:Porphyrins / Q000627:therapeutic use; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology
D005466:Fluorocarbons; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; C042852:perflutren; D007208:Indocyanine Green