One-year results of reduced-fluence photodynamic therapy for polypoidal choroidal vasculopathy.
OBJECTIVE
To report 1-year results of reduced-fluence photodynamic therapy (PDT) for polypoidal choroidal vasculopathy (PCV) in Japanese patients.


METHODS
Prospective interventional case series.


METHODS
In the present study, 28 treatment-naïve eyes of 28 consecutive patients underwent PDT with a reduced laser fluence of 25 J/cm(2). Patients were followed up at baseline and 1 week and 3, 6, 9, and 12 months after PDT. Choroidal perfusion changes were evaluated by indocyanine green angiography (ICGA) and leakage from PCV lesions and exudative changes by fluorescein angiography and optical coherence tomography. Treatment safety was assessed according to visual acuity (VA) and adverse events. The best-corrected VA (BCVA) obtained by Landolt ring tests was converted into the logarithm of the minimal angle of resolution (logMAR).


RESULTS
At baseline, the mean logMAR BCVA was 0.45 (geometric mean: 7/20). At 12 months, the mean logMAR BCVA significantly improved to 0.29 (geometric mean: 10/20) (P = 0.0001). The logMAR BCVA was stable or improved by >or=0.2 in 26 eyes (93%) at 1-year follow-up. In 10 eyes with VA better than 20/40 at baseline, the mean logMAR BCVA was significantly improved compared with baseline at 12 months. Although 16 of 28 eyes (57%) showed mild to moderate nonperfusion of choriocapillaris in early ICGA at 1 week, 27 eyes (96%) showed recovery to pretreatment levels at 3 months. Mean number of treatment sessions during the 12 months was 1.3. No severe side effects related to treatment were encountered.


CONCLUSIONS
Reduced-fluence PDT is an effective treatment for PCV and could improve vision even in eyes with VA better than 20/40.
Yamashita
Ayana
A
Department of Ophthalmology, Kagawa University Faculty of Medicine, Miki-cho, Kida-gun, Kagawa, Japan. bourjois@med.kagawa-u.ac.jp
Shiraga
Fumio
F
Shiragami
Chieko
C
Ono
Aoi
A
Tenkumo
Kaori
K
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000188:drug therapy*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use; D011166:Porphyrins / Q000009:adverse effects / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology
D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D007208:Indocyanine Green