title: Two-year visual outcome of polypoidal choroidal vasculopathy treated with photodynamic therapy combined with intravitreal injections of ranibizumab.
abstract: OBJECTIVE
  To investigate the 2-year outcomes of photodynamic therapy (PDT) combined with intravitreal injections of ranibizumab for polypoidal choroidal vasculopathy (PCV).
  
  
  METHODS
  Ninety-five eyes with subfoveal PCV treated with combined therapy were followed for ≥24 months. The association between visual outcomes and single nucleotide polymorphisms in ARMS2 A69S and CFH I62V genes were examined without adjusting for multiple comparisons.
  
  
  RESULTS
  Visual acuity (VA) improvement was observed at month 3 (P = 0.009). The improvement persisted until month 12 (P = 0.003), when VA began the decline back to baseline values at month 24. To investigate the factors associated with VA reduction during the second year, patients were divided into those with and those without a second-year VA reduction. Both patients with and without a second-year VA reduction showed similar VA changes over the first year. The first-year VA improvement was not predictive of the VA decline over the second year. Genetic analyses showed no significant difference in the frequency of the A risk allele of CFH I62V between patients with and without a second-year VA reduction. However, patients with the T risk allele of A69S had a higher rate of recurrence and were more likely to experience a reduction in VA during the second year when compared to patients without (P = 0.020 and P = 0.048, respectively).
  
  
  CONCLUSIONS
  PDT combined therapy resulted in significant visual recovery in the first year, which was not sustained during the second year. VA reduction in the second year was affected by genetic factors.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hata
authors.forename: Akitaka
authors.initials: A
authors.lastname: Tsujikawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Miyake
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamashiro
authors.forename: Sotaro
authors.initials: S
authors.lastname: Ooto
authors.forename: Akio
authors.initials: A
authors.lastname: Oishi
authors.forename: Isao
authors.initials: I
authors.lastname: Nakata
authors.forename: Ayako
authors.initials: A
authors.lastname: Takahashi
authors.forename: Nagahisa
authors.initials: N
authors.lastname: Yoshimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D003131:Combined Modality Therapy; D017242:Complement Factor H / Q000235:genetics; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D060005:Genotyping Techniques; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D016133:Polymerase Chain Reaction; D020641:Polymorphism, Single Nucleotide; D011127:Polyps / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D011506:Proteins / Q000235:genetics; D000069579:Ranibizumab; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology*
chemical_list: C514392:ARMS2 protein, human; D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C493495:CFH protein, human; D011506:Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D017242:Complement Factor H; D000069579:Ranibizumab