title: Photodynamic therapy for polypoidal choroidal vasculopathy.
abstract: The first effective therapy for exudative macular degeneration (AMD) was Photodynamic Therapy (PDT). Diagnosis of the disease was to a large extent by fluorescein angiography (FA). Distinguishing between the leaky choroidal neovessels (CNV) associated with exudative AMD, and the polypoidal structures associated with Polypoidal Choroidal Vasculopathy (PCV) is not always easy using FA alone. The switch to Indocyanine Green angiography helped to pinpoint PCV, and thus to study the efficacy of photodynamic therapy of this particular form of retinal disease, which is more frequently encountered among pigmented individuals. The results appear to be quite promising, and in the year following treatment only a small fraction of the patients had to be retreated. Alternatively, treating PCV with repeated intravitreal VEGF blocking agents was not as successful as it was in the treatment of wet AMD. However, combining PDT-induced angio-occlusion of the polypoidal lesions with anti-vascular endothelial growth factor therapy was shown to be quite effective, and the combination of PDT with an anti-angiogenic agent as well as a steroid, in a triple therapy, was recently also shown to be a quite promising option. In the present article we review the data on PDT of PCV, including combination therapies and alternative treatments. We also report on similarities and differences between AMD and PCV.
authors.affiliation: Institute of Chemical Sciences and Engineering, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland; University Hospital (CHUV), Lausanne, Switzerland. Electronic address: Patrycja.Nowak-Sliwinska@epfl.ch.
authors.forename: Patrycja
authors.initials: P
authors.lastname: Nowak-Sliwinska
authors.forename: Hubert
authors.initials: H
authors.lastname: van den Bergh
authors.forename: Michel
authors.initials: M
authors.lastname: Sickenberg
authors.forename: Adrian H C
authors.initials: AH
authors.lastname: Koh
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D015862:Choroid Diseases / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D003131:Combined Modality Therapy / Q000379:methods; D004359:Drug Therapy, Combination / Q000379:methods; D006801:Humans; D028022:Low-Level Light Therapy; D008268:Macular Degeneration / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use
chemical_list: D020533:Angiogenesis Inhibitors; D017319:Photosensitizing Agents
keywords: 11-cis-RAL; 11-cis-REH; 11-cis-retinal; 11-cis-retinyl ester hydrolase; A2E; A2PE; ABCA4; AMD; AREDS; ATP-binding cassette transporter 4; Age-related macular degeneration; Anti-Angiogenesis; BCVA; BPDMA; BVN; CFH; CNV; CRALBP; Choroidal neovascularization; ELN; ETDRS; Early Treatment Diabetic Retinopathy Study; FV; HTRA1; ICGA; IVB; IVTA; LRAT; MII; N-ret-PE; N-retinylidine-phosphatidyl ethanolamine; OCT; OS; Optical coherence tomography; PCV; PDGF; PE; PED; PEGF; PTPC; Polypoidal choroidal vasculopathy; RDH; ROS; RPED; SMA; SNP; V(®)-PDT; VDA; VEGF-A; Visudyne(®)-photodynamic therapy; age-related eye disease study; age-related macular degeneration; all-trans-RAL; all-trans-RE; all-trans-retinal; all-trans-retinal ester; benzoporphyrin derivative monoacid ring A; best-corrected visual acuity; branching vascular network; cellular retinaldehyde-binding protein; choroidal neovascularization; complement factor H; di-retinoid-pyridinium-ethanolamine; elastin gene; epithelium-derived growth factor; feeder vessels; high temperature required factor A1; indocyanine green angiography; intravitreal ranibizumab; intravitreal triamcinolone acetonide; lecithin:retinol acyltransferase; mTOR; mammalian target of rapamycin; metarhodopsin II; optical coherence tomography; outer segment; permeability transition pore complex; phosphatidylethanolamine; phosphatidylpyridinium-bisretinoid; pigment epithelial detachment; platelet-derived growth factor; polypoidal choroidal vasculopathy; reactive oxygen species; retinal pigmented epithelium detachment; retinol dehydrogenase enzymes; single nucleotide polymorphism; smooth muscle actin; vWf; vascular disrupting agent; vascular endothelial growth factor A; von Willebrand factor