title: Reduced-fluence photodynamic therapy and anti-vascular endothelial growth factor for polypoidal choroidal vasculopathy in an Indian population.
abstract: OBJECTIVE
  The aim was to study the efficacy of combined therapy with reduced-fluence photodynamic therapy (RFPDT) and intravitreal bevacizumab/ranibizumab from the Indian subcontinent.
  
  
  METHODS
  This was a single-center, retrospective interventional study.
  
  
  METHODS
  Thirty-five eyes of 34 patients diagnosed with polypoidal choroidal vasculopathy were included. All the patients underwent RFPDT, followed by intravitreal bevacizumab/ranibizumab.
  
  
  METHODS
  SPSS software, version 17.0 (SPSS Inc., Chicago, IL, USA) was used to compare the logarithm of the minimal angle of resolution visual acuity at presentation and final follow-up. P< 0.05 was considered statistically significant.
  
  
  RESULTS
  Regression of polyps after a single session of RFPDT was seen in five eyes; multiple sessions of treatment were required in thirty eyes. An average number of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections given were 4 ± 1.9 and average number of PDT sessions were 1.2 ± 0.5. Visual acuity improvement was seen in 21 (60%) eyes (P < 0.001), decrease in visual acuity was seen in 7 (20%) eyes (P = 0.016), and in 7 eyes (20%), vision remained stable. Regression of polypoidal lesions was seen in 80% of cases. No complications of massive subretinal hemorrhage or breakthrough vitreous hemorrhage were noted in our patients. The mean follow-up period was 18 months (range, 12-24 months).
  
  
  CONCLUSIONS
  RFPDT with anti-VEGF is safe and effective treatment with polyp regression and vision improvement in 80% of cases, without any complication of subretinal hemorrhage/vitreous hemorrhage.
authors.affiliation: Department of Vitreoretinal Services, Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
authors.forename: Parveen
authors.initials: P
authors.lastname: Sen
authors.affiliation: Department of Vitreoretinal Services, Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
authors.forename: Muna
authors.initials: M
authors.lastname: Bhende
authors.affiliation: Deaprtment of Optometry, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
authors.forename: Ramya
authors.initials: R
authors.lastname: Sachidanandam
authors.affiliation: Department of Vitreoretinal Services, Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
authors.forename: Nishat
authors.initials: N
authors.lastname: Bansal
authors.affiliation: Department of Vitreoretinal Services, Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Sharma
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000068258:Bevacizumab / Q000008:administration & dosage*; D002829:Choroid / Q000098:blood supply; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007194:India / Q000453:epidemiology; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011127:Polyps / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000069579:Ranibizumab / Q000008:administration & dosage*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D017319:Photosensitizing Agents; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab