Treatment of PCV with a Combination of PDT and Intravitreal Bevacizumab
The following retrospective, observational study evaluated the long-term visual outcome following combination therapy of photodynamic therapy (PDT) with intravitreal bevacizumab injections for polypoidal choroidal vasculopathy (PCV).
The medical records of 34 eyes (34 patients) with naïve PCV who were treated with combination therapy were analyzed. All patients completed at least three years of follow-up and all clinical data, including age, best-corrected visual acuity (BCVA, logarithm of the minimum angle resolution [logMAR]), imaging data of fluorescein angiography, indocyanine green angiography and optical coherence tomography, were investigated.
During a mean follow-up period of 46.82 ± 5.22 months, means of 1.44 ± 0.71 times of PDT and 9.18 ± 6.61 intravitreal bevacizumab injections were performed. During follow-up, 21 eyes (61.8%) showed at least one recurrence. It was noted that mean BCVA was 0.59 ± 0.35 logMAR (20/77 Snellen equivalent) at baseline, and 0.39 ± 0.34 logMAR (20/49 Snellen equivalent) at three years (p=0.004). At three years, it was reported that 14 patients (41.2%) gained 0.3 logMAR or more BCVA, and four patients (11.8%) lost 0.3 logMAR or more BCVA than baseline. Baseline polyp size (B=0.551; p=0.005) and location of polyps (B=–0.400; p=0.033) were significantly correlated with long-term visual outcome after combination therapy for PCV.
Combination therapy of PDT with intravitreal bevacizumab injections showed favorable visual outcomes, and significant visual improvement was maintained in PCV patients. A total of 88.2% of patients avoided visual loss at three years after treatments. Largest polyp size at baseline and location of polypoidal lesions were prognostic factors for long-term visual outcomes in these patients.