Two-year outcome of photodynamic therapy combined with intravitreal injection of bevacizumab and triamcinolone acetonide for polypoidal choroidal vasculopathy

Graefes Arch Clin Exp Ophthalmol. 2013 Apr;251(4):1073-80. doi: 10.1007/s00417-012-2137-y. Epub 2012 Aug 25.

Abstract

Purpose: To compare the 2-year results after photodynamic therapy (PDT) alone and PDT combined with intravitreal injections of bevacizumab and triamcinolone acetonide (triple therapy) for polypoidal choroidal vasculopathy (PCV).

Methods: We retrospectively reviewed the medical records of 40 consecutive patients (40 eyes) with subfoveal PCV. Of these 40 eyes, 16 were treated with PDT alone and 24 were treated with triple therapy.

Results: The change in visual acuity in the triple therapy group was significantly better than that in the PDT group (P < 0.001). At 24 months, improvement in visual acuity was seen in only two eyes (12.5 %) of the PDT group, while it was seen in ten eyes (41.7 %) of the triple therapy group. Retreatment was given to 12 eyes (75.0 %) in the PDT group and to nine eyes (37.5 %) in the triple therapy group, although the retreatment-free period was significantly longer in the triple therapy group than in the PDT group (P < 0.001). Post-treatment vitreous hemorrhage was seen in only two eyes (12.5 %), all of which were in the PDT group.

Conclusion: Compared with PDT alone, triple therapy appears to reduce the postoperative hemorrhagic complications and recurrences of PCV and to improve the 2-year visual outcomes of PCV.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Bevacizumab
  • Choroid / blood supply
  • Choroid Diseases / drug therapy*
  • Choroid Diseases / physiopathology
  • Combined Modality Therapy
  • Drug Therapy, Combination
  • Female
  • Fluorescein Angiography
  • Glucocorticoids / therapeutic use*
  • Humans
  • Intravitreal Injections
  • Male
  • Photochemotherapy*
  • Polyps / drug therapy*
  • Polyps / physiopathology
  • Retreatment
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Triamcinolone Acetonide / therapeutic use*
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology
  • Vitreous Hemorrhage / prevention & control

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Glucocorticoids
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Triamcinolone Acetonide