title: Five-year results of photodynamic therapy with and without supplementary antivascular endothelial growth factor treatment for polypoidal choroidal vasculopathy.
abstract: BACKGROUND
  To clarify the long-term efficacy of photodynamic therapy (PDT) in patients with symptomatic polypoidal choroidal vasculopathy (PCV).
  
  
  METHODS
  We retrospectively reviewed 60 naive eyes of 59 patients (45 men, 14 women; mean age, 73.8 years) treated with full-fluence PDT (PDT group) and followed for at least 60 months. Retreatment was either antivascular endothelial growth factor (VEGF) therapy or intravitreal triamcinolone acetonide if PDT alone was ineffective (supplemental retreatment group).
  
  
  RESULTS
  The mean logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) levels at baseline and 60 months were 0.66 and 0.71, respectively. The mean change at 60 months was a decrease of 0.50 line. In the PDT group (36 eyes), the mean BCVAs at baseline and month 60 were 0.73 and 0.68, respectively (p = 0.60). In the supplemental retreatment group (24 eyes), the mean BCVAs at baseline and month 60 were 0.55 and 0.74, respectively (p = 0.076). The percentage of eyes with decreased BCVA at the time of the additional anti-VEGF treatment was significantly (p = 0.031) higher than at month 60. The risk factors identified by multiple regression analysis with a significant decrease in BCVA at month 60 were a large greatest linear dimension (GLD), classic choroidal neovascularization at baseline, and a hemorrhage over the arcade vessels after PDT.
  
  
  CONCLUSIONS
  The efficacy of PDT for PCV depends on the GLD. Twenty-four of the 60 eyes needed additional treatment other than only PDT during 60 months of follow-up. Additional anti-VEGF treatment may help maintain the BCVA of patients with exudative or anatomic recurrence.
authors.affiliation: Department of Ophthalmology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan, smasaaki@fmu.ac.jp.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Saito
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Iida
authors.forename: Mariko
authors.initials: M
authors.lastname: Kano
authors.forename: Kanako
authors.initials: K
authors.lastname: Itagaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D015862:Choroid Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004396:Coloring Agents; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D011127:Polyps / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D011166:Porphyrins / Q000627:therapeutic use; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D004396:Coloring Agents; D005938:Glucocorticoids; D011166:Porphyrins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000077362:Verteporfin; D014222:Triamcinolone Acetonide; D007208:Indocyanine Green
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