Abstract

PURPOSE
To investigate the responses to photodynamic therapy (PDT) in patients with polypoidal choroidal vasculopathy (PCV) that show large aneurysmal dilation with internal angio-architecture consisting of diverse patterns of curvilinear vessels and polyps resembling grape clusters.
DESIGN
Retrospective, interventional case series.
METHODS
Twenty-two eyes of 22 patients were included. All patients initially received PDT monotreatment. The main outcome measures were the rates of complete polyp regression on indocyanine green angiography and initial favorable responses observed clinically. Also, the rates of recurrent exudative changes were evaluated at the 2-year follow-up. We focused on changes in the vascular features and their clinical association.
RESULTS
Complete regression of polypoidal lesions was observed in 21 eyes (95%) after a mean of 1.7 PDTs. However, favorable clinical responses were achieved in only 9 eyes (41%), and 6 of them had recurrent exudation. Main vessels, previously consisting of the polypoidal lesion frame, persisted. Additionally, aberrant vessels with a thin radiating or tortuous configuration were observed in the area where large aneurysmal dilation was present. Leakage from this vascular complex or an expanded vascular complex was observed in a total of 14 eyes (64%) during the 2-year follow-up, contributing to persistent (8 eyes) or recurrent (6 eyes) exudation. This seemed to represent secondary choroidal neovascularization (CNV). In another 4 eyes (18%), fibrous changes developed immediately after PDT. Polyps recurred in 8 eyes (38%).
CONCLUSIONS
This PCV pattern frequently evolved into typical CNV after PDT, resulting in persistent or recurrent exudation despite the disappearance of polypoidal structures.

Links

Publisher Full Text

Authors

Lee WK, Kim KS, Kim W, Lee SB, Jeon S

Institution

Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. wklee@catholic.ac.kr

Source

American journal of ophthalmology 154:2 2012 Aug pg 355-365.e1

MeSH

Aged
Aged, 80 and over
Aneurysm
Choroid
Choroid Diseases
Coloring Agents
Female
Fluorescein Angiography
Humans
Indocyanine Green
Male
Middle Aged
Photochemotherapy
Photosensitizing Agents
Polyps
Porphyrins
Retreatment
Retrospective Studies
Treatment Outcome
Visual Acuity

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22541658