title: Photodynamic therapy versus combination therapy in polypoidal choroidal vasculopathy: changes of aqueous vascular endothelial growth factor.
abstract: OBJECTIVE
  To investigate the influence of photodynamic therapy (PDT) and combination of PDT and ranibizumab on aqueous humor levels of vascular endothelial growth factor (VEGF) in polypoidal choroidal vasculopathy (PCV).
  
  
  METHODS
  Prospective randomized clinical trial.
  
  
  METHODS
  We included 20 eyes with treatment-naïve PCV and 20 eyes undergoing cataract surgery as controls. PCV eyes were randomized to treatment with PDT alone or to a combination of ranibizumab and PDT on the same day. During 3 months, retreatment was not performed. Aqueous humors were collected at baseline and at 1 week, 1 month, and 3 months after treatment in the PCV group and during cataract surgery in the control group. VEGF levels were measured using multiplex bead immunoassay.
  
  
  RESULTS
  At baseline, VEGF levels were significantly increased in PCV eyes compared with control eyes. A significant decrease in VEGF levels was found at 1 week after PDT treatment (n = 8) and at all time points after combination treatment (n = 12). With combination treatment, VEGF levels were decreased to values below the detection limit in all eyes at 1 week and 1 month and in 7 of 12 eyes at 3 months. There was no difference in the clinical profiles among the 2 treatment groups at each time point.
  
  
  CONCLUSIONS
  Decreased levels of VEGF detected 1 week after PDT for PCV seems to reflect acute damage of vascular endothelial cells, one of the VEGF expression sites in PCV. Concomitant ranibizumab resulted in a further decrease in VEGF to negligible levels, but this result did not affect the clinical results for 3 months.
authors.affiliation: Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, South Korea.
authors.forename: Mee Yon
authors.initials: MY
authors.lastname: Lee
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Lee
authors.forename: Jiwon
authors.initials: J
authors.lastname: Baek
authors.forename: Oh Woong
authors.initials: OW
authors.lastname: Kwon
authors.forename: Jin Hae
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001082:Aqueous Humor / Q000378:metabolism*; D002829:Choroid / Q000098:blood supply; D015862:Choroid Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D004396:Coloring Agents; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007118:Immunoassay; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D010778:Photochemotherapy; D011127:Polyps / Q000188:drug therapy* / Q000378:metabolism; D011446:Prospective Studies; D000069579:Ranibizumab; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D007208:Indocyanine Green; D000069579:Ranibizumab