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Reduced-fluence photodynamic therapy combined with intravitreal bevacizumab for polypoidal choroidal vasculopathy.
Am J Ophthalmol 2012; 153(5):873-882.e2AJ

Abstract

PURPOSE

To evaluate the efficacy and safety of reduced-fluence photodynamic therapy (PDT) combined with bevacizumab for polypoidal choroidal vasculopathy (PCV).

DESIGN

Prospective, noncomparative, interventional case series.

METHODS

Sixteen treatment-naïve patients with polypoidal choroidal vasculopathy were treated with reduced-fluence PDT combined with bevacizumab. All patients were followed up monthly for 12 months with measurements of best-corrected visual acuity (BCVA) and central foveal thickness by optical coherence tomography. Indocyanine green angiography and fluorescein angiography were performed every 3 months. Patients were re-treated with reduced-fluence PDT combined with bevacizumab or with sole injection of bevacizumab when indicated.

RESULTS

The mean logMAR BCVA showed significant improvement from 0.76 at baseline to 0.46 at 12 months (P = .002). At 12 months, the BCVA improved in 9 eyes (56.3%) by 3 lines or more, was stable in 6 eyes (37.5%), and decreased in 1 eye (6.3%) because of recurrence of polyps. During the study period, 3 patients (18.8%) had recurrence of polyps and 2 patients (12.5%) had persistent polyps. Mean episodes of reduced-fluence PDT and mean injections of intravitreal bevacizumab over 12 months were 1.44 and 2.44, respectively. Although 3 patients had mild choroidal nonperfusion-1 eye after 1 session of PDT and 2 eyes after 2 sessions-no severe complications, including endophthalmitis, uveitis, or subretinal hemorrhage, developed.

CONCLUSION

Reduced-fluence PDT combined with bevacizumab for PCV seemed to be effective for improving vision and reducing complications. Further study to optimize the light dose of PDT in combination therapy is needed in order to achieve better treatment outcomes for PCV.

Authors+Show Affiliations

Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22265146

Citation

Sagong, Min, et al. "Reduced-fluence Photodynamic Therapy Combined With Intravitreal Bevacizumab for Polypoidal Choroidal Vasculopathy." American Journal of Ophthalmology, vol. 153, no. 5, 2012, pp. 873-882.e2.
Sagong M, Lim S, Chang W. Reduced-fluence photodynamic therapy combined with intravitreal bevacizumab for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2012;153(5):873-882.e2.
Sagong, M., Lim, S., & Chang, W. (2012). Reduced-fluence photodynamic therapy combined with intravitreal bevacizumab for polypoidal choroidal vasculopathy. American Journal of Ophthalmology, 153(5), pp. 873-882.e2. doi:10.1016/j.ajo.2011.09.031.
Sagong M, Lim S, Chang W. Reduced-fluence Photodynamic Therapy Combined With Intravitreal Bevacizumab for Polypoidal Choroidal Vasculopathy. Am J Ophthalmol. 2012;153(5):873-882.e2. PubMed PMID: 22265146.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced-fluence photodynamic therapy combined with intravitreal bevacizumab for polypoidal choroidal vasculopathy. AU - Sagong,Min, AU - Lim,Suho, AU - Chang,Woohyok, Y1 - 2012/01/20/ PY - 2010/11/24/received PY - 2011/09/28/revised PY - 2011/09/28/accepted PY - 2012/1/24/entrez PY - 2012/1/24/pubmed PY - 2012/6/15/medline SP - 873 EP - 882.e2 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 153 IS - 5 N2 - PURPOSE: To evaluate the efficacy and safety of reduced-fluence photodynamic therapy (PDT) combined with bevacizumab for polypoidal choroidal vasculopathy (PCV). DESIGN: Prospective, noncomparative, interventional case series. METHODS: Sixteen treatment-naïve patients with polypoidal choroidal vasculopathy were treated with reduced-fluence PDT combined with bevacizumab. All patients were followed up monthly for 12 months with measurements of best-corrected visual acuity (BCVA) and central foveal thickness by optical coherence tomography. Indocyanine green angiography and fluorescein angiography were performed every 3 months. Patients were re-treated with reduced-fluence PDT combined with bevacizumab or with sole injection of bevacizumab when indicated. RESULTS: The mean logMAR BCVA showed significant improvement from 0.76 at baseline to 0.46 at 12 months (P = .002). At 12 months, the BCVA improved in 9 eyes (56.3%) by 3 lines or more, was stable in 6 eyes (37.5%), and decreased in 1 eye (6.3%) because of recurrence of polyps. During the study period, 3 patients (18.8%) had recurrence of polyps and 2 patients (12.5%) had persistent polyps. Mean episodes of reduced-fluence PDT and mean injections of intravitreal bevacizumab over 12 months were 1.44 and 2.44, respectively. Although 3 patients had mild choroidal nonperfusion-1 eye after 1 session of PDT and 2 eyes after 2 sessions-no severe complications, including endophthalmitis, uveitis, or subretinal hemorrhage, developed. CONCLUSION: Reduced-fluence PDT combined with bevacizumab for PCV seemed to be effective for improving vision and reducing complications. Further study to optimize the light dose of PDT in combination therapy is needed in order to achieve better treatment outcomes for PCV. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/22265146/Reduced_fluence_photodynamic_therapy_combined_with_intravitreal_bevacizumab_for_polypoidal_choroidal_vasculopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(11)00780-X DB - PRIME DP - Unbound Medicine ER -