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23.03.2020 | Clinical Investigation

Effectiveness of polypoidal lesion-selective photodynamic therapy with intravitreal antivascular endothelial growth factor for polypoidal choroidal vasculopathy

verfasst von: Yuki Komuku, Chiharu Iwahashi, Fumi Gomi

Erschienen in: Japanese Journal of Ophthalmology | Ausgabe 3/2020

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Abstract

Purpose

To evaluate the 24-month effectiveness of polypoidal lesion-selective photodynamic therapy (PDT) combined with antivascular endothelial growth factor (VEGF) therapy for polypoidal choroidal vasculopathy (PCV) with branching vascular networks (BVNs) involving the fovea with 1 or more polyps.

Study design

A retrospective case series.

Patients and methods

Twenty-six eyes from 25 PCV patients treated with polypoidal lesion-selective PDT combined with aflibercept were included in the study. The main outcome measure was change in best-corrected visual acuity (BCVA), and the secondary outcome measures were changes in central retinal thickness and subfoveal choroidal thickness on optical coherence tomography (OCT), status of exudation at 24 months, and number of additional treatments.

Results

Fourteen eyes of 14 patients showed treatment-naïve PCV, and 12 eyes of 11 patients were switched from anti-VEGF monotherapy. The baseline mean logMAR BCVA was 0.43, and this had increased significantly, by 0.31, at 24 months (P = .034). The mean central retinal thickness (CRT) and central choroidal thickness (CCT) were significantly lower at all time points than those at baseline. The mean number of additional injections of aflibercept was 3.1 (range, 0–9), and that of additional PDT treatments was 0.5 (range, 0–2).

Conclusion

Polypoidal lesion-selective PDT with aflibercept was effective for relatively large, fovea-involved PCV, with significant visual improvement at 24 months.
Literatur
1.
Zurück zum Zitat Spaide RF, Yannuzzi LA, Slakter JS, Sorenson J, Orlach DA. Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy. Retina. 1995;15:100–10.CrossRef Spaide RF, Yannuzzi LA, Slakter JS, Sorenson J, Orlach DA. Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy. Retina. 1995;15:100–10.CrossRef
2.
Zurück zum Zitat Yamamoto A, Okada AA, Kano M, Koizumi H, Saito M, Maruko I, et al. One-year results of intravitreal aflibercept for polypoidal choroidal vasculopathy. Ophthalmology. 2015;122:1866–72.CrossRef Yamamoto A, Okada AA, Kano M, Koizumi H, Saito M, Maruko I, et al. One-year results of intravitreal aflibercept for polypoidal choroidal vasculopathy. Ophthalmology. 2015;122:1866–72.CrossRef
3.
Zurück zum Zitat Chan W-M, Lam DS, Lai TY, Liu DT, Li KK, Yao Y, et al. Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy. Ophthalmology. 2004;111:1576–84.CrossRef Chan W-M, Lam DS, Lai TY, Liu DT, Li KK, Yao Y, et al. Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy. Ophthalmology. 2004;111:1576–84.CrossRef
4.
Zurück zum Zitat Gomi F, Ohji M, Sayanagi K, Sawa M, Sakaguchi H, Oshima Y, et al. One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese Patients. Ophthalmology. 2008;115:141–6.CrossRef Gomi F, Ohji M, Sayanagi K, Sawa M, Sakaguchi H, Oshima Y, et al. One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese Patients. Ophthalmology. 2008;115:141–6.CrossRef
5.
Zurück zum Zitat Honda S, Imai H, Yamashiro K, Kurimoto Y, Kanamori-Matsui N, Kagotani Y, et al. Comparative assessment of photodynamic therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy: a multicenter study in Hyogo prefecture. Japan. Ophthalmologica. 2009;223:333–8.CrossRef Honda S, Imai H, Yamashiro K, Kurimoto Y, Kanamori-Matsui N, Kagotani Y, et al. Comparative assessment of photodynamic therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy: a multicenter study in Hyogo prefecture. Japan. Ophthalmologica. 2009;223:333–8.CrossRef
6.
Zurück zum Zitat Lee MY, Lee K, Baek J, Kwon OW, Lee H. Photodynamic therapy versus combination therapy in polypoidal choroidal vasculopathy: changes of aqueous vascular endothelial growth factor. Am J Ophthalmol. 2013;156:343–8.CrossRef Lee MY, Lee K, Baek J, Kwon OW, Lee H. Photodynamic therapy versus combination therapy in polypoidal choroidal vasculopathy: changes of aqueous vascular endothelial growth factor. Am J Ophthalmol. 2013;156:343–8.CrossRef
7.
Zurück zum Zitat Lai TYY, Lee GKY, Luk FOJ, Lam DSC. Intravitreal ranibizumab with or without photodynamic therapy for the treatment of symptomatic polypoidal choroidal vasculopathy. Retina. 2011;31:1581–8.CrossRef Lai TYY, Lee GKY, Luk FOJ, Lam DSC. Intravitreal ranibizumab with or without photodynamic therapy for the treatment of symptomatic polypoidal choroidal vasculopathy. Retina. 2011;31:1581–8.CrossRef
8.
Zurück zum Zitat Takayama K, Kaneko H, Kataoka K, Hattori K, Ra E, Tsunekawa T, et al. Comparison between 1-year outcomes of aflibercept with and without photodynamic therapy for polypoidal choroidal vasculopathy: retrospective observation study. PLoS One. 2017;12:1–12.CrossRef Takayama K, Kaneko H, Kataoka K, Hattori K, Ra E, Tsunekawa T, et al. Comparison between 1-year outcomes of aflibercept with and without photodynamic therapy for polypoidal choroidal vasculopathy: retrospective observation study. PLoS One. 2017;12:1–12.CrossRef
9.
Zurück zum Zitat Schmidt-Erfurth U, Michels S, Barbazetto I, Laqua H. Photodynamic effects on choroidal neovascularization and physiological choroid. Invest Ophthalmol Vis Sci. 2002;43:830–41.PubMed Schmidt-Erfurth U, Michels S, Barbazetto I, Laqua H. Photodynamic effects on choroidal neovascularization and physiological choroid. Invest Ophthalmol Vis Sci. 2002;43:830–41.PubMed
10.
Zurück zum Zitat Schmidt-Erfurth U, Laqua H, Schlötzer-Schrehard U, Viestenz A, Naumann GOH. Histopathological changes following photodynamic therapy in human eyes. Arch Ophthalmol. 2002;120:835–44.PubMed Schmidt-Erfurth U, Laqua H, Schlötzer-Schrehard U, Viestenz A, Naumann GOH. Histopathological changes following photodynamic therapy in human eyes. Arch Ophthalmol. 2002;120:835–44.PubMed
11.
Zurück zum Zitat Cheung CMG, Lai TYY, Ruamviboonsuk P, Chen SJ, Chen Y, Freund KB, et al. Polypoidal choroidal vasculopathy: definition, pathogenesis, diagnosis, and management. Ophthalmology. 2018;125:708–24.CrossRef Cheung CMG, Lai TYY, Ruamviboonsuk P, Chen SJ, Chen Y, Freund KB, et al. Polypoidal choroidal vasculopathy: definition, pathogenesis, diagnosis, and management. Ophthalmology. 2018;125:708–24.CrossRef
12.
Zurück zum Zitat Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials–TAP report. Arch Ophthalmol. 1999;117:1329–45. Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials–TAP report. Arch Ophthalmol. 1999;117:1329–45.
13.
Zurück zum Zitat Tsujikawa A, Ojima Y, Yamashiro K, Nakata I, Ooto S, Tamura H, et al. Association of lesion size and visual prognosis to polypoidal choroidal vasculopathy. Am J Ophthalmol. 2011;151:961–72.CrossRef Tsujikawa A, Ojima Y, Yamashiro K, Nakata I, Ooto S, Tamura H, et al. Association of lesion size and visual prognosis to polypoidal choroidal vasculopathy. Am J Ophthalmol. 2011;151:961–72.CrossRef
14.
Zurück zum Zitat Suzuki M, Nagai N, Shinoda H, Uchida A, Kurihara T, Tomita Y, et al. Distinct responsiveness to intravitreal ranibizumab therapy in polypoidal choroidal vasculopathy with single or multiple polyps. Am J Ophthalmol. 2016;166:52–9.CrossRef Suzuki M, Nagai N, Shinoda H, Uchida A, Kurihara T, Tomita Y, et al. Distinct responsiveness to intravitreal ranibizumab therapy in polypoidal choroidal vasculopathy with single or multiple polyps. Am J Ophthalmol. 2016;166:52–9.CrossRef
15.
Zurück zum Zitat Suzuki M, Gomi F, Sawa M, Ueno C, Nishida K. Changes in fundus autofluorescence in polypoidal choroidal vasculopathy during 3 years of follow-up. Graefe’s Arch Clin Exp Ophthalmol. 2013;251:2331–7.CrossRef Suzuki M, Gomi F, Sawa M, Ueno C, Nishida K. Changes in fundus autofluorescence in polypoidal choroidal vasculopathy during 3 years of follow-up. Graefe’s Arch Clin Exp Ophthalmol. 2013;251:2331–7.CrossRef
16.
Zurück zum Zitat Koh A, Lai TYY, Takahashi K, Wong TY, Chen L-J, Ruamviboonsuk P, et al. Efficacy and safety of ranibizumab with or without verteporfin photodynamic therapy for polypoidal choroidal vasculopathy: a randomized clinical trial. JAMA Ophthalmol. 2017;135:1206–13.CrossRef Koh A, Lai TYY, Takahashi K, Wong TY, Chen L-J, Ruamviboonsuk P, et al. Efficacy and safety of ranibizumab with or without verteporfin photodynamic therapy for polypoidal choroidal vasculopathy: a randomized clinical trial. JAMA Ophthalmol. 2017;135:1206–13.CrossRef
17.
Zurück zum Zitat Kikushima W, Sakurada Y, Sugiyama A, Tanabe N, Kume A, Iijima H. Comparison of initial treatment between 3-monthly intravitreal aflibercept monotherapy and combined photodynamic therapy with single intravitreal aflibercept for polypoidal choroidal vasculopathy. Graefe’s Arch Clin Exp Ophthalmol. 2017;255:311–6.CrossRef Kikushima W, Sakurada Y, Sugiyama A, Tanabe N, Kume A, Iijima H. Comparison of initial treatment between 3-monthly intravitreal aflibercept monotherapy and combined photodynamic therapy with single intravitreal aflibercept for polypoidal choroidal vasculopathy. Graefe’s Arch Clin Exp Ophthalmol. 2017;255:311–6.CrossRef
18.
Zurück zum Zitat Mori R, Yuzawa M, Akaza E, Haruyama M. Treatment results at 1 year of ranibizumab therapy for polypoidal choroidal vasculopathy in eyes with good visual acuity. Jpn J Ophthalmol. 2013;57:365–71.CrossRef Mori R, Yuzawa M, Akaza E, Haruyama M. Treatment results at 1 year of ranibizumab therapy for polypoidal choroidal vasculopathy in eyes with good visual acuity. Jpn J Ophthalmol. 2013;57:365–71.CrossRef
19.
Zurück zum Zitat Miyata M, Ooto S, Yamashiro K, Tamura H, Hata M, Ueda-Arakawa N, et al. Five-year visual outcomes after anti-VEGF therapy with or without photodynamic therapy for polypoidal choroidal vasculopathy. Br J Ophthalmol. 2018. Miyata M, Ooto S, Yamashiro K, Tamura H, Hata M, Ueda-Arakawa N, et al. Five-year visual outcomes after anti-VEGF therapy with or without photodynamic therapy for polypoidal choroidal vasculopathy. Br J Ophthalmol. 2018.
20.
Zurück zum Zitat Wakabayashi T, Gomi F, Sawa M, Tsujikawa M, Tano Y. Marked vascular changes of polypoidal choroidal vasculopathy after photodynamic therapy. Br J Ophthalmol. 2008;92:936–40.CrossRef Wakabayashi T, Gomi F, Sawa M, Tsujikawa M, Tano Y. Marked vascular changes of polypoidal choroidal vasculopathy after photodynamic therapy. Br J Ophthalmol. 2008;92:936–40.CrossRef
21.
Zurück zum Zitat Lai TY, Chan WM, Lam DS. Transient reduction in retinal function revealed by multifocal electroretinogram after photodynamic therapy. Am J Ophthalmol. 2004;137:826–33.CrossRef Lai TY, Chan WM, Lam DS. Transient reduction in retinal function revealed by multifocal electroretinogram after photodynamic therapy. Am J Ophthalmol. 2004;137:826–33.CrossRef
22.
Zurück zum Zitat Park SJ, Choi Y, Na YM, Hong HK, Park JY, Park KH, et al. Intraocular pharmacokinetics of intravitreal aflibercept (Eylea) in a rabbit model. Invest Ophthalmol Vis Sci. 2016;57:2612–7.CrossRef Park SJ, Choi Y, Na YM, Hong HK, Park JY, Park KH, et al. Intraocular pharmacokinetics of intravitreal aflibercept (Eylea) in a rabbit model. Invest Ophthalmol Vis Sci. 2016;57:2612–7.CrossRef
23.
Zurück zum Zitat Nakai S, Matsumiya W, Otsuka K, Miki A, Nakamura M, Honda S. The 24-month outcomes of intravitreal aflibercept combined with photodynamic therapy for polypoidal choroidal vasculopathy. Jpn J Ophthalmol. 2019;63:100–8.CrossRef Nakai S, Matsumiya W, Otsuka K, Miki A, Nakamura M, Honda S. The 24-month outcomes of intravitreal aflibercept combined with photodynamic therapy for polypoidal choroidal vasculopathy. Jpn J Ophthalmol. 2019;63:100–8.CrossRef
24.
Zurück zum Zitat Maruko I, Iida T, Sugano Y, Ojima A, Ogasawara M, Spaide RF. Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology. 2010;117:1792–9.CrossRef Maruko I, Iida T, Sugano Y, Ojima A, Ogasawara M, Spaide RF. Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology. 2010;117:1792–9.CrossRef
25.
Zurück zum Zitat Maruko I, Iida T, Oyamada H, Sugano Y, Ojima A, Sekiryu T. Choroidal thickness changes after intravitreal ranibizumab and photodynamic therapy in recurrent polypoidal choroidal vasculopathy. Am J Ophthalmol. 2013;156:548–56.CrossRef Maruko I, Iida T, Oyamada H, Sugano Y, Ojima A, Sekiryu T. Choroidal thickness changes after intravitreal ranibizumab and photodynamic therapy in recurrent polypoidal choroidal vasculopathy. Am J Ophthalmol. 2013;156:548–56.CrossRef
26.
Zurück zum Zitat Gomi F, Oshima Y, Mori R, Kano M, Saito M, Yamashita A, et al. Initial versus delayed photodynamic therapy in combination with ranibizumab for treatment of polypoidal choroidal vasculopathy. Retina. 2015;35:1569–76.CrossRef Gomi F, Oshima Y, Mori R, Kano M, Saito M, Yamashita A, et al. Initial versus delayed photodynamic therapy in combination with ranibizumab for treatment of polypoidal choroidal vasculopathy. Retina. 2015;35:1569–76.CrossRef
Metadaten
Titel
Effectiveness of polypoidal lesion-selective photodynamic therapy with intravitreal antivascular endothelial growth factor for polypoidal choroidal vasculopathy
verfasst von
Yuki Komuku
Chiharu Iwahashi
Fumi Gomi
Publikationsdatum
23.03.2020
Verlag
Springer Japan
Erschienen in
Japanese Journal of Ophthalmology / Ausgabe 3/2020
Print ISSN: 0021-5155
Elektronische ISSN: 1613-2246
DOI
https://doi.org/10.1007/s10384-020-00734-3

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