Macular atrophy at 5 years after photodynamic therapy for polypoidal choroidal vasculopathy.

Abstract

PURPOSE:

To investigate predictors for macular atrophy (MA) involving the fovea after photodynamic therapy (PDT) followed by pro re nata (PRN) treatment for polypoidal choroidal vasculopathy (PCV).

METHODS:

This prospective observational study analysed treatment-naïve eyes with symptomatic PCV without MA at baseline which were followed up for 5 years. All eyes were initially treated with PDT, followed by a PRN regimen of anti-vascular endothelial growth factor (VEGF) therapy and/or PDT. We assigned eyes with and eyes without development of MA involving the fovea 5 years after the initial treatment into MA and non-MA groups, respectively. Baseline parameters and the number of treatments were compared between the two groups.

RESULTS:

Seventy-two eyes of 69 consecutive patients were included, and 29 eyes of 29 patients were analysed. Twelve (41%) and 17 (59%) eyes were assigned into the MA and non-MA groups, respectively. There were significant differences in subfoveal choroidal thickness (226.2 ± 47.8 μm vs. 278.8 ± 68.1 μm, P = 0.03) and number of anti-VEGF injections (13.7 ± 9.6 vs. 5.4 ± 5.6, P = 0.007) between the MA and non-MA groups, but not in the number of PDT sessions (P = 0.71). Best-corrected visual acuity at 5 years in the MA group was lower than in the non-MA group (P = 0.048).

CONCLUSION:

Our long-term observation suggests that a thin subfoveal choroid at baseline and many followed anti-VEGF injections in a PRN regimen increase the risk for development of MA involving the fovea 5 years after PDT.

• Authors: Kentaro Kawai, Manabu Miyata, Sotaro Ooto, Hiroshi Tamura, Naoko Ueda-Arakawa, Ayako Takahashi, Akihito Uji, Yuki Muraoka, Masahiro Miyake, Kenji Yamashiro, Akitaka Tsujikawa
• Journal: Eye (London, England) (Eye (Lond)) Vol. 37 Issue 6 Pg. 1067-1072 (04 2023) ISSN: 1476-5454 [Electronic] England
• PMID: 35422494 (Publication Type: Observational Study, Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.

Chemical References

• Angiogenesis Inhibitors
• Vascular Endothelial Growth Factor A

Topics

• Humans
• Angiogenesis Inhibitors (therapeutic use)
• Vascular Endothelial Growth Factor A (therapeutic use)
• Polypoidal Choroidal Vasculopathy
• Photochemotherapy
• Follow-Up Studies
• Intravitreal Injections
• Macular Degeneration (drug therapy)
• Fluorescein Angiography
• Atrophy
• Retrospective Studies
• Tomography, Optical Coherence