title: Responses to photodynamic therapy in patients with polypoidal choroidal vasculopathy consisting of polyps resembling grape clusters.
abstract: OBJECTIVE
  To investigate the responses to photodynamic therapy (PDT) in patients with polypoidal choroidal vasculopathy (PCV) that show large aneurysmal dilation with internal angio-architecture consisting of diverse patterns of curvilinear vessels and polyps resembling grape clusters.
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  Twenty-two eyes of 22 patients were included. All patients initially received PDT monotreatment. The main outcome measures were the rates of complete polyp regression on indocyanine green angiography and initial favorable responses observed clinically. Also, the rates of recurrent exudative changes were evaluated at the 2-year follow-up. We focused on changes in the vascular features and their clinical association.
  
  
  RESULTS
  Complete regression of polypoidal lesions was observed in 21 eyes (95%) after a mean of 1.7 PDTs. However, favorable clinical responses were achieved in only 9 eyes (41%), and 6 of them had recurrent exudation. Main vessels, previously consisting of the polypoidal lesion frame, persisted. Additionally, aberrant vessels with a thin radiating or tortuous configuration were observed in the area where large aneurysmal dilation was present. Leakage from this vascular complex or an expanded vascular complex was observed in a total of 14 eyes (64%) during the 2-year follow-up, contributing to persistent (8 eyes) or recurrent (6 eyes) exudation. This seemed to represent secondary choroidal neovascularization (CNV). In another 4 eyes (18%), fibrous changes developed immediately after PDT. Polyps recurred in 8 eyes (38%).
  
  
  CONCLUSIONS
  This PCV pattern frequently evolved into typical CNV after PDT, resulting in persistent or recurrent exudation despite the disappearance of polypoidal structures.
authors.affiliation: Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. wklee@catholic.ac.kr
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Lee
authors.forename: Kyu Seop
authors.initials: KS
authors.lastname: Kim
authors.forename: Wungjae
authors.initials: W
authors.lastname: Kim
authors.forename: Seung Bum
authors.initials: SB
authors.lastname: Lee
authors.forename: Sohee
authors.initials: S
authors.lastname: Jeon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000175:diagnosis / Q000188:drug therapy; D002829:Choroid / Q000098:blood supply; D015862:Choroid Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011127:Polyps / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D011166:Porphyrins / Q000627:therapeutic use; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology
chemical_list: D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D007208:Indocyanine Green