Five-year follow-up results of photodynamic therapy for polypoidal choroidal vasculopathy

Purpose To evaluate the 5-year efficacy of photodynamic therapy (PDT) in patients with polypoidal choroidal vasculopathy (PCV). Methods Forty-two eyes of 36 patients with PCV followed up for at least 60 months after PDT were retrospectively reviewed. The diagnosis of PCV was based on indocyanine green angiography (ICGA), showing branching vascular network with polypoidal components. All eyes were primarily treated with PDT, and retreated with PDT and anti-vascular endothelial growth factor (VEGF) injection or with only anti-VEGF injection. The recurrence of PCV was defined as the emergence of active polypoidal lesions observed with fluorescein angiography (FA) and ICGA. Retreatment was performed when leakage of fluorescein or subretinal fluid/intraretinal cyst on optical coherence tomography was noted during follow-up examiinations. Results During the mean follow-up duration, 73.64±13.47 months, the mean number of PDT was 2.21±1.62 times, and the mean number of anti-VEGF injection was 5.05±5.55 times. Recurrence was noted in 33 eyes (78.6%) during follow-up. The mean baseline BCVA was 0.78±0.48 logarithm of the minimum angle of resolution (logMAR), and the final BCVA at 60-month follow-up was 0.68±0.54 logMAR. On the final evaluation at 60 months, the mean BCVA was improved in 14 eyes (33.3%) by at least 0.3 logMAR, stable (mean BCVA change within 0.2 logMAR from baseline) in 23 eyes (54.7%), and decreased in 5 eyes (11.9%) by at least 0.3 logMAR. Conclusion After 5 years, 88.1% of patients showed stable or improved BCVA after PDT. Despite of high recurrence rate up to 78.6%, PDT was effective for 5 years, and seems to be a good option of treatment in PCV patients.