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Combined Photodynamic Therapy With Intravitreal Bevacizumab Injections for Polypoidal Choroidal Vasculopathy: Long-term Visual Outcome

 Hae Min Kang  ;  Hyoung Jun Koh  ;  Christopher Seungkyu Lee  ;  Sung Chul Lee 
 AMERICAN JOURNAL OF OPHTHALMOLOGY, Vol.157(3) : 598-606, 2014 
Journal Title
Issue Date
Angiogenesis Inhibitors/therapeutic use* ; Antibodies, Monoclonal, Humanized/therapeutic use* ; Bevacizumab ; Choroidal Neovascularization/diagnosis ; Choroidal Neovascularization/drug therapy* ; Choroidal Neovascularization/physiopathology ; Coloring Agents ; Combined Modality Therapy ; Female ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Intravitreal Injections ; Male ; Middle Aged ; Photochemotherapy* ; Polyps/diagnosis ; Polyps/drug therapy* ; Polyps/physiopathology ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/physiology*
PURPOSE: To evaluate the long-term visual outcome after combination therapy of photodynamic therapy (PDT) with intravitreal bevacizumab injections for polypoidal choroidal vasculopathy (PCV). DESIGN: Retrospective observational study. METHODS: The medical records of 34 eyes (34 patients) with naïve PCV who were treated with combination therapy were analyzed. All patients completed at least 3 years of follow-up. All clinical data, including age, best-corrected visual acuity (BCVA, logarithm of the minimal angle of resolution [logMAR]), imaging data of fluorescein angiography, indocyanine green angiography, and optical coherence tomography, were investigated. RESULTS: During a mean follow-up period of 46.8 ± 5.2 months, a mean of 1.4 ± 0.71 times of PDT and 9.2 ± 6.6 intravitreal bevacizumab injections were performed. During follow-up, 21 eyes (61.8%) showed at least 1 recurrence. Mean BCVA was 0.59 ± 0.35 logMAR (20/77 Snellen equivalent) at baseline and 0.39 ± 0.34 logMAR (20/49 Snellen equivalent) at 3 years (P = .004). At 3 years, 14 patients (41.2%) gained 0.3 logMAR or more BCVA and 4 patients (11.8%) lost 0.3 logMAR or more BCVA than baseline. Baseline polyp size (β = .551; P = .005) and location of polyps (β = -.400; P =.033) were significantly correlated with long-term visual outcome after combination therapy for PCV. CONCLUSIONS: Combination therapy of PDT with intravitreal bevacizumab injections showed favorable visual outcomes, and significant visual improvement was maintained in PCV patients. A total of 88.2% of patients avoided visual loss at 3 years after treatments. Largest polyp size at baseline and location of polypoidal lesions were prognostic factors for long-term visual outcomes in these patients.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hyoung Jun(고형준) ORCID logo https://orcid.org/0000-0002-5932-8516
Lee, Sung Chul(이성철) ORCID logo https://orcid.org/0000-0001-9438-2385
Lee, Christopher Seungkyu(이승규) ORCID logo https://orcid.org/0000-0001-5054-9470
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