title: Adjusted retreatment of polypoidal choroidal vasculopathy after combination therapy: results at 3 years.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the 3-year outcome of adjusted retreatment with photodynamic therapy (PDT), thermal laser, and intravitreal bevacizumab (IVB) after their initial PDT/IVB combination therapy for polypoidal choroidal vasculopathy.
  
  
  METHODS
  Data on 40 treatment-naive eyes of 38 patients with polypoidal choroidal vasculopathy were reviewed, all initially subjected to whole-lesion PDT/IVB. When retreating persistent or recurrent exudation, the aim was to reduce PDT frequency and spot size, avoiding whole-lesion PDT when feasible. Distinct polyps were thus selectively targeted using PDT and/or laser, routinely combined with IVB. If polyps were absent or questionable, IVB monotherapy was given.
  
  
  RESULTS
  At Year 3, the mean logarithm of minimal angle of resolution best-corrected visual acuity improved from 0.67 (Snellen equivalent of 20/93) to 0.55 (Snellen equivalent of 20/70), but the improvement was not statistically significant (P = 0.076). Best-corrected visual acuity remained stable or improved in 33 eyes (82.5%). The mean number of combination treatments and total IVB courses were 1.66 (range, 1-4) and 5.92 (range, 1-18), respectively. Five eyes (12.5%) required focal laser treatment for extrafoveal polypoidal lesions during follow-up.
  
  
  CONCLUSIONS
  Compared with reported 3-year outcomes of PDT as monotherapy for polypoidal choroidal vasculopathy, this approach proved favorable in improving or stabilizing visual acuity and reducing cumulative PDT exposure.
authors.affiliation: Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sohee
authors.initials: S
authors.lastname: Jeon
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Lee
authors.forename: Kyu Seop
authors.initials: KS
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D002829:Choroid / Q000098:blood supply; D015862:Choroid Diseases / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D011127:Polyps / Q000628:therapy*; D019233:Retreatment / Q000379:methods; D012189:Retrospective Studies; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab