Marked vascular changes of polypoidal choroidal vasculopathy after photodynamic therapy.
OBJECTIVE
To clarify vascular changes of polypoidal choroidal vasculopathy (PCV) after photodynamic therapy (PDT).


METHODS
Thirty-one eyes underwent PDT with verteporfin and were followed every 3 months with indocyanine green angiography (ICGA) using confocal scanning ophthalmoscope and optical coherence tomography (OCT) for over 15 months and the findings recorded.


RESULTS
The mean follow-up period was 19.2 months. Regression of the polypoidal lesions were confirmed once in 29 eyes (94%) on ICGA and OCT. Some lesions recurred at the initial regions (n = 5 eyes), at different regions connected to the branching vascular network (n = 4 eyes), and at both regions (n = 1 eye) (mean 11.4 (SD 1.9) months) after initial PDT. The branching vascular network remained in all eyes and enlarged in 13 eyes (42%) at the final visit. The vascular features of residual branching vascular networks changed (n = 7 eyes); fibrinous subretinal exudation developed (n = 4 eyes), and the retinal pigment epithelium was elevated similar to vascularised pigment epithelial detachment (n = 3 eyes).


CONCLUSIONS
Polypoidal lesions of PCV are treatable with PDT; however, they often recur. The branching vascular networks do not regress and allow the recurrence of polypoidal lesions at the network termini. Alterations of the vascular features may occur; careful observation is needed after PDT.
Wakabayashi
T
T
Department of Ophthalmology, Osaka University Medical School, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
Gomi
F
F
Sawa
M
M
Tsujikawa
M
M
Tano
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000188:drug therapy*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D007208:Indocyanine Green