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Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 4/2013

01.04.2013 | Retinal Disorders

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

verfasst von: Isao Nakata, Akitaka Tsujikawa, Kenji Yamashiro, Atsushi Otani, Sotaro Ooto, Yumiko Akagi-Kurashige, Naoko Ueda-Arakawa, Daisuke Iwama, Nagahisa Yoshimura

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 4/2013

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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.
Literatur
1.
Zurück zum Zitat Bressler NM, Arnold J, Benchaboune M, Blumenkranz MS, Fish GE, Gragoudas ES, Lewis H, Schmidt-Erfurth U, Slakter JS, Bressler SB, Manos K, Hao Y, Hayes L, Koester J, Reaves A, Strong HA (2002) Verteporfin therapy of subfoveal choroidal neovascularization in patients with age-related macular degeneration: additional information regarding baseline lesion composition’s impact on vision outcomes—TAP report No. 3. Arch Ophthalmol 120:1443–1454PubMed Bressler NM, Arnold J, Benchaboune M, Blumenkranz MS, Fish GE, Gragoudas ES, Lewis H, Schmidt-Erfurth U, Slakter JS, Bressler SB, Manos K, Hao Y, Hayes L, Koester J, Reaves A, Strong HA (2002) Verteporfin therapy of subfoveal choroidal neovascularization in patients with age-related macular degeneration: additional information regarding baseline lesion composition’s impact on vision outcomes—TAP report No. 3. Arch Ophthalmol 120:1443–1454PubMed
2.
Zurück zum Zitat Avery RL, Pieramici DJ, Rabena MD, Castellarin AA, Nasir MA, Giust MJ (2006) Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration. Ophthalmology 113:363–372, e365PubMedCrossRef Avery RL, Pieramici DJ, Rabena MD, Castellarin AA, Nasir MA, Giust MJ (2006) Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration. Ophthalmology 113:363–372, e365PubMedCrossRef
3.
Zurück zum Zitat Heier JS, Antoszyk AN, Pavan PR, Leff SR, Rosenfeld PJ, Ciulla TA, Dreyer RF, Gentile RC, Sy JP, Hantsbarger G, Shams N (2006) Ranibizumab for treatment of neovascular age-related macular degeneration: a phase I/II multicenter, controlled, multidose study. Ophthalmology 113(633):e631–e634 Heier JS, Antoszyk AN, Pavan PR, Leff SR, Rosenfeld PJ, Ciulla TA, Dreyer RF, Gentile RC, Sy JP, Hantsbarger G, Shams N (2006) Ranibizumab for treatment of neovascular age-related macular degeneration: a phase I/II multicenter, controlled, multidose study. Ophthalmology 113(633):e631–e634
4.
Zurück zum Zitat Michels S, Rosenfeld PJ, Puliafito CA, Marcus EN, Venkatraman AS (2005) Systemic bevacizumab (Avastin) therapy for neovascular age-related macular degeneration twelve-week results of an uncontrolled open-label clinical study. Ophthalmology 112:1035–1047PubMedCrossRef Michels S, Rosenfeld PJ, Puliafito CA, Marcus EN, Venkatraman AS (2005) Systemic bevacizumab (Avastin) therapy for neovascular age-related macular degeneration twelve-week results of an uncontrolled open-label clinical study. Ophthalmology 112:1035–1047PubMedCrossRef
5.
Zurück zum Zitat Martin DF, Maguire MG, Ying GS, Grunwald JE, Fine SL, Jaffe GJ (2011) Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med 364:1897–1908PubMedCrossRef Martin DF, Maguire MG, Ying GS, Grunwald JE, Fine SL, Jaffe GJ (2011) Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med 364:1897–1908PubMedCrossRef
6.
Zurück zum Zitat Ahmadieh H, Taei R, Soheilian M, Riazi-Esfahani M, Karkhaneh R, Lashay A, Azarmina M, Dehghan MH, Moradian S (2007) Single-session photodynamic therapy combined with intravitreal bevacizumab and triamcinolone for neovascular age-related macular degeneration. BMC Ophthalmol 7:10PubMedCrossRef Ahmadieh H, Taei R, Soheilian M, Riazi-Esfahani M, Karkhaneh R, Lashay A, Azarmina M, Dehghan MH, Moradian S (2007) Single-session photodynamic therapy combined with intravitreal bevacizumab and triamcinolone for neovascular age-related macular degeneration. BMC Ophthalmol 7:10PubMedCrossRef
7.
Zurück zum Zitat Yip PP, Woo CF, Tang HH, Ho CK (2009) Triple therapy for neovascular age-related macular degeneration using single-session photodynamic therapy combined with intravitreal bevacizumab and triamcinolone. Br J Ophthalmol 93:754–758PubMedCrossRef Yip PP, Woo CF, Tang HH, Ho CK (2009) Triple therapy for neovascular age-related macular degeneration using single-session photodynamic therapy combined with intravitreal bevacizumab and triamcinolone. Br J Ophthalmol 93:754–758PubMedCrossRef
8.
Zurück zum Zitat Ciardella AP, Donsoff IM, Huang SJ, Costa DL, Yannuzzi LA (2004) Polypoidal choroidal vasculopathy. Surv Ophthalmol 49:25–37PubMedCrossRef Ciardella AP, Donsoff IM, Huang SJ, Costa DL, Yannuzzi LA (2004) Polypoidal choroidal vasculopathy. Surv Ophthalmol 49:25–37PubMedCrossRef
9.
Zurück zum Zitat Sho K, Takahashi K, Yamada H, Wada M, Nagai Y, Otsuji T, Nishikawa M, Mitsuma Y, Yamazaki Y, Matsumura M, Uyama M (2003) Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics. Arch Ophthalmol 121:1392–1396PubMedCrossRef Sho K, Takahashi K, Yamada H, Wada M, Nagai Y, Otsuji T, Nishikawa M, Mitsuma Y, Yamazaki Y, Matsumura M, Uyama M (2003) Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics. Arch Ophthalmol 121:1392–1396PubMedCrossRef
10.
Zurück zum Zitat Maruko I, Iida T, Saito M, Nagayama D, Saito K (2007) Clinical characteristics of exudative age-related macular degeneration in Japanese patients. Am J Ophthalmol 144:15–22PubMedCrossRef Maruko I, Iida T, Saito M, Nagayama D, Saito K (2007) Clinical characteristics of exudative age-related macular degeneration in Japanese patients. Am J Ophthalmol 144:15–22PubMedCrossRef
11.
Zurück zum Zitat Kokame GT, Yeung L, Lai JC (2010) Continuous anti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy: 6-month results. Br J Ophthalmol 94:297–301PubMedCrossRef Kokame GT, Yeung L, Lai JC (2010) Continuous anti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy: 6-month results. Br J Ophthalmol 94:297–301PubMedCrossRef
12.
Zurück zum Zitat Hikichi T, Ohtsuka H, Higuchi M, Matsushita T, Ariga H, Kosaka S, Matsushita R, Takami K (2010) Improvement of angiographic findings of polypoidal choroidal vasculopathy after intravitreal injection of ranibizumab monthly for 3 months. Am J Ophthalmol 150:674–682, e671PubMedCrossRef Hikichi T, Ohtsuka H, Higuchi M, Matsushita T, Ariga H, Kosaka S, Matsushita R, Takami K (2010) Improvement of angiographic findings of polypoidal choroidal vasculopathy after intravitreal injection of ranibizumab monthly for 3 months. Am J Ophthalmol 150:674–682, e671PubMedCrossRef
13.
Zurück zum Zitat Spaide RF, Donsoff I, Lam DL, Yannuzzi LA, Jampol LM, Slakter J, Sorenson J, Freund KB (2002) Treatment of polypoidal choroidal vasculopathy with photodynamic therapy. Retina 22:529–535PubMedCrossRef Spaide RF, Donsoff I, Lam DL, Yannuzzi LA, Jampol LM, Slakter J, Sorenson J, Freund KB (2002) Treatment of polypoidal choroidal vasculopathy with photodynamic therapy. Retina 22:529–535PubMedCrossRef
14.
Zurück zum Zitat Gomi F, Ohji M, Sayanagi K, Sawa M, Sakaguchi H, Oshima Y, Ikuno Y, Tano Y (2008) One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients. Ophthalmology 115:141–146PubMedCrossRef Gomi F, Ohji M, Sayanagi K, Sawa M, Sakaguchi H, Oshima Y, Ikuno Y, Tano Y (2008) One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients. Ophthalmology 115:141–146PubMedCrossRef
15.
Zurück zum Zitat Tsuchiya D, Yamamoto T, Kawasaki R, Yamashita H (2009) Two-year visual outcomes after photodynamic therapy in age-related macular degeneration patients with or without polypoidal choroidal vasculopathy lesions. Retina 29:960–965PubMedCrossRef Tsuchiya D, Yamamoto T, Kawasaki R, Yamashita H (2009) Two-year visual outcomes after photodynamic therapy in age-related macular degeneration patients with or without polypoidal choroidal vasculopathy lesions. Retina 29:960–965PubMedCrossRef
16.
Zurück zum Zitat Yamashiro K, Tsujikawa A, Nishida A, Mandai M, Kurimoto Y (2008) Recurrence of polypoidal choroidal vasculopathy after photodynamic therapy. Jpn J Ophthalmol 52:457–462PubMedCrossRef Yamashiro K, Tsujikawa A, Nishida A, Mandai M, Kurimoto Y (2008) Recurrence of polypoidal choroidal vasculopathy after photodynamic therapy. Jpn J Ophthalmol 52:457–462PubMedCrossRef
17.
Zurück zum Zitat Kurashige Y, Otani A, Sasahara M, Yodoi Y, Tamura H, Tsujikawa A, Yoshimura N (2008) Two-year results of photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol 146:513–519PubMedCrossRef Kurashige Y, Otani A, Sasahara M, Yodoi Y, Tamura H, Tsujikawa A, Yoshimura N (2008) Two-year results of photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol 146:513–519PubMedCrossRef
18.
Zurück zum Zitat Gomi F, Sawa M, Wakabayashi T, Sasamoto Y, Suzuki M, Tsujikawa M (2010) Efficacy of intravitreal bevacizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol 150:48–54PubMedCrossRef Gomi F, Sawa M, Wakabayashi T, Sasamoto Y, Suzuki M, Tsujikawa M (2010) Efficacy of intravitreal bevacizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol 150:48–54PubMedCrossRef
19.
Zurück zum Zitat Sato T, Kishi S, Matsumoto H, Mukai R (2010) Combined photodynamic therapy with verteporfin and intravitreal bevacizumab for polypoidal choroidal vasculopathy. Am J Ophthalmol 149:947–995PubMedCrossRef Sato T, Kishi S, Matsumoto H, Mukai R (2010) Combined photodynamic therapy with verteporfin and intravitreal bevacizumab for polypoidal choroidal vasculopathy. Am J Ophthalmol 149:947–995PubMedCrossRef
20.
Zurück zum Zitat Ruamviboonsuk P, Tadarati M, Vanichvaranont S, Hanutsaha P, Pokawattana N (2010) Photodynamic therapy combined with ranibizumab for polypoidal choroidal vasculopathy: results of a 1-year preliminary study. Br J Ophthalmol 94:1045–1051PubMedCrossRef Ruamviboonsuk P, Tadarati M, Vanichvaranont S, Hanutsaha P, Pokawattana N (2010) Photodynamic therapy combined with ranibizumab for polypoidal choroidal vasculopathy: results of a 1-year preliminary study. Br J Ophthalmol 94:1045–1051PubMedCrossRef
21.
Zurück zum Zitat Obata R, Iriyama A, Inoue Y, Takahashi H, Tamaki Y, Yanagi Y (2007) Triamcinolone acetonide suppresses early proangiogenic response in retinal pigment epithelial cells after photodynamic therapy in vitro. Br J Ophthalmol 91:100–104PubMedCrossRef Obata R, Iriyama A, Inoue Y, Takahashi H, Tamaki Y, Yanagi Y (2007) Triamcinolone acetonide suppresses early proangiogenic response in retinal pigment epithelial cells after photodynamic therapy in vitro. Br J Ophthalmol 91:100–104PubMedCrossRef
22.
Zurück zum Zitat Wang YS, Friedrichs U, Eichler W, Hoffmann S, Wiedemann P (2002) Inhibitory effects of triamcinolone acetonide on bFGF-induced migration and tube formation in choroidal microvascular endothelial cells. Graefes Arch Clin Exp Ophthalmol 240:42–48PubMedCrossRef Wang YS, Friedrichs U, Eichler W, Hoffmann S, Wiedemann P (2002) Inhibitory effects of triamcinolone acetonide on bFGF-induced migration and tube formation in choroidal microvascular endothelial cells. Graefes Arch Clin Exp Ophthalmol 240:42–48PubMedCrossRef
23.
Zurück zum Zitat Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group (1999) 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 117:1329–1345 Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group (1999) 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 117:1329–1345
24.
Zurück zum Zitat Otani A, Sasahara M, Yodoi Y, Aikawa H, Tamura H, Tsujikawa A, Yoshimura N (2007) Indocyanine green angiography: guided photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol 144:7–14PubMedCrossRef Otani A, Sasahara M, Yodoi Y, Aikawa H, Tamura H, Tsujikawa A, Yoshimura N (2007) Indocyanine green angiography: guided photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol 144:7–14PubMedCrossRef
25.
Zurück zum Zitat Cheng CK, Peng CH, Chang CK, Hu CC, Chen LJ (2011) One-year outcomes of intravitreal bevacizumab (Avastin) therapy for polypoidal choroidal vasculopathy. Retina 31:846–856PubMedCrossRef Cheng CK, Peng CH, Chang CK, Hu CC, Chen LJ (2011) One-year outcomes of intravitreal bevacizumab (Avastin) therapy for polypoidal choroidal vasculopathy. Retina 31:846–856PubMedCrossRef
26.
Zurück zum Zitat Chan WM, Lam DS, Lai TY, Liu DT, Li KK, Yao Y, Wong TH (2004) Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy: one-year results of a prospective case series. Ophthalmology 111:1576–1584PubMedCrossRef Chan WM, Lam DS, Lai TY, Liu DT, Li KK, Yao Y, Wong TH (2004) Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy: one-year results of a prospective case series. Ophthalmology 111:1576–1584PubMedCrossRef
27.
Zurück zum Zitat Schmidt-Erfurth U, Schlotzer-Schrehard U, Cursiefen C, Michels S, Beckendorf A, Naumann GO (2003) Influence of photodynamic therapy on expression of vascular endothelial growth factor (VEGF), VEGF receptor 3, and pigment epithelium-derived factor. Invest Ophthalmol Vis Sci 44:4473–4480PubMedCrossRef Schmidt-Erfurth U, Schlotzer-Schrehard U, Cursiefen C, Michels S, Beckendorf A, Naumann GO (2003) Influence of photodynamic therapy on expression of vascular endothelial growth factor (VEGF), VEGF receptor 3, and pigment epithelium-derived factor. Invest Ophthalmol Vis Sci 44:4473–4480PubMedCrossRef
28.
Zurück zum Zitat Tatar O, Adam A, Shinoda K, Stalmans P, Eckardt C, Luke M, Bartz-Schmidt KU, Grisanti S (2006) Expression of VEGF and PEDF in choroidal neovascular membranes following verteporfin photodynamic therapy. Am J Ophthalmol 142:95–104PubMedCrossRef Tatar O, Adam A, Shinoda K, Stalmans P, Eckardt C, Luke M, Bartz-Schmidt KU, Grisanti S (2006) Expression of VEGF and PEDF in choroidal neovascular membranes following verteporfin photodynamic therapy. Am J Ophthalmol 142:95–104PubMedCrossRef
29.
Zurück zum Zitat Okubo A, Ito M, Kamisasanuki T, Sakamoto T (2005) Visual improvement following trans-Tenon’s retrobulbar triamcinolone acetonide infusion for polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol 243:837–839PubMedCrossRef Okubo A, Ito M, Kamisasanuki T, Sakamoto T (2005) Visual improvement following trans-Tenon’s retrobulbar triamcinolone acetonide infusion for polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol 243:837–839PubMedCrossRef
30.
Zurück zum Zitat Mukai R, Kishi S, Sato T, Watanabe G, Matsumoto H (2010) Protective effect of intravitreal bevacizumab and sub-tenon triamcinolone acetonide against occlusion of choriocapillaris induced by photodynamic therapy. Ophthalmologica 224:267–273PubMedCrossRef Mukai R, Kishi S, Sato T, Watanabe G, Matsumoto H (2010) Protective effect of intravitreal bevacizumab and sub-tenon triamcinolone acetonide against occlusion of choriocapillaris induced by photodynamic therapy. Ophthalmologica 224:267–273PubMedCrossRef
31.
Zurück zum Zitat Lai TY, Lam CP, Luk FO, Chan RP, Chan WM, Liu DT, Lam DS (2010) Photodynamic therapy with or without intravitreal triamcinolone acetonide for symptomatic polypoidal choroidal vasculopathy. J Ocul Pharmacol Ther 26:91–95PubMedCrossRef Lai TY, Lam CP, Luk FO, Chan RP, Chan WM, Liu DT, Lam DS (2010) Photodynamic therapy with or without intravitreal triamcinolone acetonide for symptomatic polypoidal choroidal vasculopathy. J Ocul Pharmacol Ther 26:91–95PubMedCrossRef
32.
Zurück zum Zitat Hirami Y, Tsujikawa A, Otani A, Yodoi Y, Aikawa H, Mandai M, Yoshimura N (2007) Hemorrhagic complications after photodynamic therapy for polypoidal choroidal vasculopathy. Retina 27:335–341PubMedCrossRef Hirami Y, Tsujikawa A, Otani A, Yodoi Y, Aikawa H, Mandai M, Yoshimura N (2007) Hemorrhagic complications after photodynamic therapy for polypoidal choroidal vasculopathy. Retina 27:335–341PubMedCrossRef
33.
Zurück zum Zitat Papadopoulou DN, Mendrinos E, Mangioris G, Donati G, Pournaras CJ (2009) Intravitreal ranibizumab may induce retinal arteriolar vasoconstriction in patients with neovascular age-related macular degeneration. Ophthalmology 116:1755–1761PubMedCrossRef Papadopoulou DN, Mendrinos E, Mangioris G, Donati G, Pournaras CJ (2009) Intravitreal ranibizumab may induce retinal arteriolar vasoconstriction in patients with neovascular age-related macular degeneration. Ophthalmology 116:1755–1761PubMedCrossRef
34.
Zurück zum Zitat Koh A, Lee WK, Chen LJ, Chen SJ, Hashad Y, Kim H, Lai TY, Pilz S, Ruamviboonsuk P, Tokaji E, Weisberger A, Lim TH (2012) EVEREST STUDY: Efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina Mar 21 [Epub ahead of print] Koh A, Lee WK, Chen LJ, Chen SJ, Hashad Y, Kim H, Lai TY, Pilz S, Ruamviboonsuk P, Tokaji E, Weisberger A, Lim TH (2012) EVEREST STUDY: Efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina Mar 21 [Epub ahead of print]
Metadaten
Titel
Two-year outcome of photodynamic therapy combined with intravitreal injection of bevacizumab and triamcinolone acetonide for polypoidal choroidal vasculopathy
verfasst von
Isao Nakata
Akitaka Tsujikawa
Kenji Yamashiro
Atsushi Otani
Sotaro Ooto
Yumiko Akagi-Kurashige
Naoko Ueda-Arakawa
Daisuke Iwama
Nagahisa Yoshimura
Publikationsdatum
01.04.2013
Verlag
Springer-Verlag
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 4/2013
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-012-2137-y

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