Photodynamic therapy combined with ranibizumab for polypoidal choroidal vasculopathy: results of a 1-year preliminary study

Background/aims To determine the potential efficacy and safety of combined verteporfin photodynamic therapy (PDT) with ranibizumab for the treatment of polypoidal choroidal vasculopathy (PCV).

Methods In this prospective, non-comparative, interventional study, 12 eyes from 12 patients that had active PCV were treated with PDT combined with three monthly intravitreal injections of ranibizumab. The patients were then monitored monthly with measurements of best-corrected visual acuity (BCVA) and central retinal thickness quantified by optical coherence tomography for 1 year. Indocyanine green angiography (ICGA) and fluorescein angiography were performed every 3 months. The eyes were re-treated with PDT and a ranibizumab injection, or with solely ranibizumab injection when indicated.

Results At month 12, the mean BCVA change from baseline was +12.3 letters (p=0.04). Eight patients (58.3%, p=0.02) had a BCVA gain of 15 letters or more. One patient (8.3%, p=1.0) had a BCVA loss of 15 letters or more. All patients underwent regression of polyps without recurrence. One patient experienced an insignificant subretinal haemorrhage. No other adverse event that could be attributed to the treatment was observed.

Conclusions This combination therapy showed encouraging results concerning improving vision, reducing the incidence of subretinal haemorrhage and reducing the recurrence of polyps when compared to previously published data that reported PDT monotherapy for PCV.