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Adjunctive photodynamic therapy for type 1 choroidal neovascularization associated with thickened choroid
Author(s) -
Kim N.,
Lee W.K.
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2015.0545
Subject(s) - medicine , choroid , choroidal neovascularization , ophthalmology , visual acuity , adjunctive treatment , photodynamic therapy , indocyanine green , refractory (planetary science) , fluorescein angiography , neovascularization , surgery , retina , angiogenesis , chemistry , physics , organic chemistry , astrobiology , optics
Purpose To evaluate the treatment outcomes of adjunctive photodynamic therapy ( PDT ) in patients with type 1 choroidal neovascularization ( CNV ) associated with thickened choroid and refractory to anti‐vascular endothelial growth factor ( VEGF ) monotherapy. Methods Data on 28 eyes of 28 patients with type 1 CNV with a minimum subfoveal choroidal thickness of 300 μ m were reviewed. All showed persistent subretinal and/or intraretinal fluid after at least 4 anti‐ VEGF injections in the 6 months before adjunctive PDT . No eyes had certain polypoidal lesions on indocyanine green angiography. The main outcomes measured included the rates of complete fluid absorption at 3 months and the change in best‐corrected visual acuity ( BCVA ) at 12 months. Results At 3 months, complete fluid absorption was observed in 24 eyes (85.7%). The mean central macular thickness significantly reduced from 342 ± 63 μ m to 242 ± 60 μ m, and the mean subfoveal choroidal thickness from 386 ± 80 μ m to 350 ± 91 μ m compared to baseline (P < 0.001, P < 0.001, respectively). Over the 1‐year follow‐up period, 17 eyes (60.7%) were free from recurrent fluid accumulation. Anti‐ VEGF injection was mainly used in the re‐treatment of persistent or recurrent exudation (mean: 1.5). At 12 months, the mean BCVA significantly improved compared to baseline (20/53 to 20/44, P = .039), and the logarithm of the minimal angle of resolution BCVA improved by ≥0.3 or maintained in 27 eyes (96.4%). Conclusions Adjunctive PDT in eyes with type 1 CNV with thickened choroid refractory to anti‐ VEGF monotherapy resulted in complete fluid absorption in most eyes, which translated to visual improvement up to 1 year.