Intravitreal Bevacizumab With or Without Photodynamic Therapy for the Treatment of Polypoidal Choroidal Vasculopathy

ABSTRACT

PURPOSE: To compare the efficacy of photodynamic therapy (PDT) using verteporfin combined with intravitreal bevacizumab and bevacizumab monotherapy in polypoidal choroidal vasculopathy (PCV). METHODS: Twenty-six eyes, diagnosed with PCV were reviewed retrospectively. They were divided into two groups combined treatment (COMB) and bevacizumab monotherapy (BEV). Visual acuity, fluorescein angiography (FA) and indocyanine green angiography (ICG) results were reviewed to compare changes in the polypoidal vessels and the branching vascular networks. RESULTS: Among 26 eyes of 26 patients, there were 12 eyes in the COMB group and 14 eyes in the BEV group. Follow-up periods were about 42 weeks and 48 weeks for the respective groups. In the COMB group, visual acuity improved from log MAR 0.92 to 0.56, whereas visual acuity in the BEV group changed only minimally from log MAR 0.98 to 0.97. In the COMB group, the polypoidal vessel resolved in six eyes. In the BEV group, the polypoidal vessel resolved in one eye. In the COMB group, the vascular network resolved in one eye, improved in ten eyes, and did not change in one eye. In the BEV group, the vascular network did not change in any of the 14 eyes. CONCLUSIONS: Combined treatment with PDT and intravitreal bevacizumab resulted in a more prolonged effect, induced the resolution of polypoidal vessels more effectively than did bevacizumab monotherapy, and is expected to reduce recurrence and retreatment.