Abstract
Purpose
To evaluate the visual outcomes and changes in abnormal vascular networks and polypoidal lesions of polypoidal choroidal vasculopathy (PCV) 3 years after photodynamic therapy (PDT).
Methods
We studied 43 eyes of 43 patients with PCV for 3 years. Fundus appearance, fluorescein angiography (FA) and indocyanine green angiography (IA) findings, and visual acuity (VA) before the initial PDT were compared with those 3 months, 1 year, 2 years, and 3 years after treatment.
Results
In 24 of the 43 eyes, enlargement of the abnormal vascular network continued in a manner similar to that before PDT on IA; in eight eyes, transformation into polypoidal choroidal neovascularization (CNV) with enlargement was detected; and two eyes had the appearance of classic CNV on FA. Polypoidal lesions recurred at 3 years in 33 of the 43 eyes (77%). Mean VA (logarithm of the minimum angle of resolution) of all 43 eyes decreased to below baseline at 3 years after the initial PDT. This decrease can be explained by foveal atrophy after absorption of recurrent hemorrhagic or exudative detachment.
Conclusion
Long-term visual outcomes were not good owing to the high frequency of recurrent polypoidal lesions, as well as enlargement and neovascular changes involving abnormal vascular networks.
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References
Yannuzzi LA, Sorenson J, Spaide RF, Lipson B. Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina 1990;10:1–8.
Yuzawa M, Mori R, Kawamura A. The origins of polypoidal choroidal vasculopathy. Br J Ophthalmol 2005;89:602–607.
Hussain N, Hussain A, Natrajan S. Role of photodynamic therapy in polypoidal choroidal vasculopathy. Indian Ophthalmol 2005; 53:101–104.
Otani A, Sasahara M, Yodoi Y, et al. Indocyanine green angiography guided photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol 2007;144:7–14.
Uyama M, Wada M, Nagai Y, et al. Polypoidal choroidal vasculopathy. Natural history. Am J Ophthalmol 2002;133:639–648.
Akaza E, Yuzawa M, Matsumoto Y, et al. Role of photodynamic therapy in polypoidal choroidal vasculopathy. Jpn J Ophthalmol 2007;51:270–277.
Akaza E, Mori R, Yuzawa M. Long-term results of photodynamic therapy of polypoidal choroidal vasculopathy. Retina 2008;28: 717–722.
Maugwt-Faysse M, Quaranta-El Maftouhi M, De La Marnierre E, Leys A. Photodynamic therapy with verteporfin in the treatment of exudative idiopathic polypoidal choroidal vasculopathy. Eur J Ophthalmol 2006;16:695–704.
Gomi F, Ohji M, Sayanagi K, et al. One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients. Ophthalmology 2008;115:141–146.
Wakabayashi T, Gomi F, Sawa M, Tsujikawa M, Tano Y. Marked vascular changes of polypoidal choroidal vasculopathy after photodynamic therapy. Br J Ophthalmol 2008;92:936–940.
Nakajima M, Yuzawa M, Shimada H, Mori R. Correlation between indocyanine green angiographic findings and histopathology of polypoidal choroidal vasculopathy. Jpn J Ophthalmol 2004;48: 249–255.
Nakashizuka H, Mitsumata M, Okisaka S, et al. Clinicopathologic findings in polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci 2008;49:4729–4737.
Spaide RF, Yannuzzi LA, Slakter JS, Sorenson J, Orlach DA. Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy. Retina 1995;15:100–110.
Mori R, Yuzawa M, Kawamura A. A Study of findings from indocyanine fundus angiography with HRA in polypoidal choroidal vasculopathy [in Japanese with English abstract]. Ganka 2004;46:193–199.
Okubo A, Samejima M, Ueda S. Pathology of polypoidal choroidal vasculopathy [in Japanese with English abstract]. Ganka 2005;47:71–77.
Okubo A, Sameshima M, Uemura A, Kanda S, Ohba N. Clinicopathological correlation of polypoidal choroidal vasculopathy revealed by ultrastructural study. Br J Ophthalmol 2002;86: 1093–1098.
Maruko I, Iida T, Saito M, Nagayama D, Saito K. Clinical characteristics of exudative age-related macular degeneration in Japanese patients. Am J Ophthalmol 2007;144:15–22.
Yannuzzi LA, Wong DW, Sforzolini BS, et al. Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration. Arch Ophthalmol 1999;117:1503–1510.
Terasaki H, Miyake Y, Suzuki T, Nakamura M, Nagasaka T. Polypoidal choroidal vasculopathy treated with macular translocation. Br J Ophthalmol 2002;86:321–327.
Lafaut BA, Aisenbrey S, Van den Broecke C, Bartz-Schmidt KU, Heimann K. Polypoidal choroidal vasculopathy pattern in agerelated macular degeneration: a clinicopathologic correlation. Retina 2000;20:650–654.
Sho K, Takahashi K, Yamada H, et al. Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics. Arch Ophthalmol 2003;121:1392–1396.
Spaide RF, Donsoff L, Lam DL, et al. Treatment of polypoidal choroidal vasculopathy with polypoidal choroidal vasculopathy. Retina 2002;22:529–535.
Dewi NA, Yuzawa M, Tochigi K, et al. Effects of photodynamic therapy on the choriocapillaris and retinal pigment epithelium in the irradiated area. Jpn J Ophthalmol 2008;52:277–281.
Lee SC, Seong YS, Kim SS, Koh HJ, Kwon OW. Photodynamic therapy with verteporfin for polypoidal choroidal vasculopathy of the macula. Ophthalmologica 2004;218:193–201.
Chan WM, Lam DS, Lai TY, et al. Photodynamic therapy with verteporfin for symptomatic polypoidal vasculopathy: one-year results of a prospective case series. Ophthalmology 2004;111:1576–1584.
Silva RM, Figueira J, Cachulo ML, et al. Polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin. Graefes Arch Clin Exp Ophthalmol 2005;243:973–979.
Eandi CM, Ober MD, Freund KB, Slakter JS, Yannuzzi LA. Selective photodynamic therapy for neovascular age-related macular degeneration with polypoidal choroidal neovascularization. Retina 2007;27:825–831.
Sayanagi K, Gomi F, Sawa M, Ohji M, Tano Y. Long-term follow-up of polypoidal choroidal vasculopathy after photodynamic therapy with verteporfin. Graefes Arch Clin Exp Ophthalmol 2007;245:1569–1571.
Ogino T, Takeda M, Imaizumi H. Photodynamic therapy for agerelated macular degeneration in Japanese patients: results after one year. Jpn J Ophthalmol 2007;51:210–215.
Spaide RF, Laud K, Fine HF, et al. Intravitreal bevacizumab treatment of choroidal neovascularization secondary to age-related macular degeneration. Retina 2006;26:383–390.
Lee SY, Kim JG, Joe SG, Chung H, Yoon YH. The therapeutic effects of bevacizumab in patients with polypoidal choroidal vasculopathy. Korean J Ophthalmol 2008;22:92–99.
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Akaza, E., Yuzawa, M. & Mori, R. Three-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy. Jpn J Ophthalmol 55, 39–44 (2011). https://doi.org/10.1007/s10384-010-0886-x
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DOI: https://doi.org/10.1007/s10384-010-0886-x