Long-Term Prognosis of Patients with Polypoidal Choroidal Vasculopathy Treated with Photodynamic Therapy

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 Jul 29

PMID 37510825

Authors

Yukinori Sakaeda

Aki Kato

Soichiro Kuwayama

Shuichiro Hirahara

Norihiro Suzuki

Yuichiro Ogura

Yoko Nakazawa

Tsutomu Yasukawa

Affiliations

Soon will be listed here.

Abstract

We evaluated the long-term prognosis of the eyes of patients with polypoidal choroidal vasculopathy (PCV) treated with photodynamic therapy (PDT). In total, 60 eyes of 57 patients diagnosed with PCV and treated with PDT were reviewed retrospectively in real-world settings. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), anatomical findings (vision-threatening findings), and treatment history were assessed. In total, 38 eyes underwent PDT as the initial treatment (initial PDT group) and 22 eyes underwent PDT as a rescue treatment (rescue PDT group). In the initial PDT group, 11 eyes (29%) did not require additional therapy throughout the observation period and maintained good BCVA. A total of 27 eyes (71%) underwent additional treatments and the mean BCVA was only stabilized for 2 years; thereafter, decreased vision occurred even with additional treatments. In the rescue PDT group, 22 eyes (95%) required additional treatment. Hard exudate, serous pigment epithelial detachment, and the total vision-threatening score were related to worse BCVA. Initial PDT may be effective in about 30% of cases with preservation of good vision and no need for additional treatment. However, patients with received rescue PDT needed additional treatment in most cases and the vision decreased in many cases.

References

Mukai R, Kataoka K, Tanaka K, Miyara Y, Maruko I, Nakayama M . Three-month outcomes of faricimab loading therapy for wet age-related macular degeneration in Japan. Sci Rep. 2023; 13(1):8747. PMC: 10229564. DOI: 10.1038/s41598-023-35759-4. View

Saito K, Yamamoto T, Tsuchiya D, Kawasaki R, Haneda S, Yamashita H . Effect of combined treatment with sub-Tenon injection of triamcinolone acetonide and photodynamic therapy in Japanese patients with age-related macular degeneration. Jpn J Ophthalmol. 2009; 53(5):512-8. DOI: 10.1007/s10384-009-0703-6. View

Koh A, Lai T, Takahashi K, Wong T, Chen L, Ruamviboonsuk P . Efficacy and Safety of Ranibizumab With or Without Verteporfin Photodynamic Therapy for Polypoidal Choroidal Vasculopathy: A Randomized Clinical Trial. JAMA Ophthalmol. 2017; 135(11):1206-1213. PMC: 5710379. DOI: 10.1001/jamaophthalmol.2017.4030. View

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(1):15-22. DOI: 10.1016/j.ajo.2007.03.047. View

Lim T, Lai T, Takahashi K, Wong T, Chen L, Ruamviboonsuk P . Comparison of Ranibizumab With or Without Verteporfin Photodynamic Therapy for Polypoidal Choroidal Vasculopathy: The EVEREST II Randomized Clinical Trial. JAMA Ophthalmol. 2020; 138(9):935-942. PMC: 7366282. DOI: 10.1001/jamaophthalmol.2020.2443. View

Sirks M, van Dijk E, Rosenberg N, Hollak C, Aslanis S, Cheung C . Clinical impact of the worldwide shortage of verteporfin (Visudyne®) on ophthalmic care. Acta Ophthalmol. 2022; 100(7):e1522-e1532. PMC: 9790583. DOI: 10.1111/aos.15148. View

Cheung C, Lee W, Koizumi H, Dansingani K, Lai T, Freund K . Pachychoroid disease. Eye (Lond). 2018; 33(1):14-33. PMC: 6328576. DOI: 10.1038/s41433-018-0158-4. View

Yamashita A, Shiraga F, Shiragami C, Shirakata Y, Fujiwara A . Two-year results of reduced-fluence photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2012; 155(1):96-102.e1. DOI: 10.1016/j.ajo.2012.06.027. View

Maruko I, Iida T, Sugano Y, Furuta M, Sekiryu T . One-year choroidal thickness results after photodynamic therapy for central serous chorioretinopathy. Retina. 2011; 31(9):1921-7. DOI: 10.1097/IAE.0b013e31822bf6b1. View

10.

Sakurai M, Baba T, Kitahashi M, Yokouchi H, Kubota-Taniai M, Bikbova G . One-year results of intravitreal ranibizumab combined with reduced-fluence photodynamic therapy for polypoidal choroidal vasculopathy. Clin Ophthalmol. 2014; 8:235-41. PMC: 3913546. DOI: 10.2147/OPTH.S54578. View

11.

Morizane Y, Morimoto N, Fujiwara A, Kawasaki R, Yamashita H, Ogura Y . Incidence and causes of visual impairment in Japan: the first nation-wide complete enumeration survey of newly certified visually impaired individuals. Jpn J Ophthalmol. 2018; 63(1):26-33. DOI: 10.1007/s10384-018-0623-4. View

12.

. Japanese age-related macular degeneration trial: 1-year results of photodynamic therapy with verteporfin in Japanese patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration. Am J Ophthalmol. 2003; 136(6):1049-61. DOI: 10.1016/s0002-9394(03)00576-2. View

13.

Gomi F, Ohji M, Sayanagi K, Sawa M, Sakaguchi H, Oshima Y . One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients. Ophthalmology. 2007; 115(1):141-6. DOI: 10.1016/j.ophtha.2007.02.031. View

14.

Nakamura K, Takeuchi J, Kataoka K, Ota H, Asai K, Nakano Y . EFFECTS OF HALF-DOSE PHOTODYNAMIC THERAPY ON CHRONIC CENTRAL SEROUS CHORIORETINOPATHY WITH OR WITHOUT MACULAR NEOVASCULARIZATION ASSESSED USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY. Retina. 2022; 42(12):2346-2353. DOI: 10.1097/IAE.0000000000003604. View

15.

Fujiwara K, Yasuda M, Hata J, Oshima Y, Hashimoto S, Yoshitomi T . Prevalence and Risk Factors for Polypoidal Choroidal Vasculopathy in a General Japanese Population: The Hisayama Study. Semin Ophthalmol. 2018; 33(6):813-819. DOI: 10.1080/08820538.2018.1506483. View

16.

Gulkas S, Sahin O . Microperimetric changes and fixation stability status after half-dose photodynamic therapy for chronic central serous chorioretinopathy. Eur J Ophthalmol. 2019; 30(5):1053-1060. DOI: 10.1177/1120672119858877. View

17.

Lee W, Iida T, Ogura Y, Chen S, Wong T, Mitchell P . Efficacy and Safety of Intravitreal Aflibercept for Polypoidal Choroidal Vasculopathy in the PLANET Study: A Randomized Clinical Trial. JAMA Ophthalmol. 2018; 136(7):786-793. PMC: 6136040. DOI: 10.1001/jamaophthalmol.2018.1804. View

18.

Ngo W, Chee W, Tan C, Lim T . Comparing efficacy of reduced-fluence and standard-fluence photodynamic therapy in the treatment of polypoidal choroidal vasculopathy. BMC Ophthalmol. 2020; 20(1):150. PMC: 7161176. DOI: 10.1186/s12886-020-01419-8. View

19.

Tano Y . Guidelines for PDT in Japan. Ophthalmology. 2008; 115(3):585-585.e6. DOI: 10.1016/j.ophtha.2007.10.018. View

20.

Sho K, Takahashi K, Yamada H, Wada M, Nagai Y, Otsuji T . Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics. Arch Ophthalmol. 2003; 121(10):1392-6. DOI: 10.1001/archopht.121.10.1392. View