HALF-DOSE PHOTODYNAMIC THERAPY COMBINED WITH BEVACIZUMAB FOR POLYPOIDAL CHOROIDAL VASCULOPATHY.

Abstract

To evaluate the efficacy of half-dose photodynamic therapy (PDT) combined with intravitreal bevacizumab (IVB) for polypoidal choroidal vasculopathy. For this retrospective comparative study, data from 57 patients (63 eyes) with at least 12 months of follow-up were reviewed. Full-dose or half-dose PDT combined with a single IVB treatment was performed according to the time period. From 3 months after the initial combination treatment, retreatment was performed mainly using anti-vascular endothelial growth factor injections on an as-needed basis. Consecutively, 33 eyes were treated with full-dose PDT/IVB and 30 eyes with half-dose PDT/IVB. At Month 3, half-dose PDT/IVB induced negligible damage to the physiologic choroid but was inferior to full-dose PDT/IVB in achieving complete polyp closure (43.3% vs. 72.7%, P = 0.018) and improving mean best-corrected visual acuity (20/66 vs. 20/43, P = 0.020). At Month 12, the half-dose group achieved comparable visual improvement (20/51 vs. 20/40, P = 0.254) but required more additional injections (a mean of 2.80 vs. 1.03, P = 0.004). Despite inferior efficacy in inducing polyp closure, half-dose PDT/IVB followed by additional injections showed promising visual outcomes while avoiding damage to the physiologic choroid. Further long-term study is needed to evaluate the efficacy of half-dose PDT plus anti-vascular endothelial growth factor for polypoidal choroidal vasculopathy.