Photodynamic therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy: a 30-month multicenter study in Hyogo, Japan

Abstract

Purpose: To evaluate the long-term effects of photodynamic therapy (PDT) on different phenotypes of age-related macular degeneration (AMD): typical AMD (tAMD) and polypoidal choroidal vasculopathy (PCV).

Methods: A multicenter prospective study of 207 eyes of 201 patients (tAMD, 123 eyes; PCV, 84 eyes) treated with PDT. Sex, age, best-corrected visual acuity (BCVA), greatest linear dimension, and lesion type were evaluated for pretreatment factors. PDT frequency, BCVA at 30 months post-PDT, frequency of recurrence, and mean recurrence period were compared as posttreatment outcomes.

Results: The 30 months post-PDT mean BCVA was significantly lower than the pre-PDT value in the tAMD group, but it remained unchanged in the PCV group. There was no difference in PDT frequency between the two groups. Multivariate analysis revealed that lesion type was the only predicting factor significantly associated with BCVA at 30 months post-PDT. The incidence of recurrence before 30 months post-PDT was not significantly different between the tAMD and PCV groups, whereas the mean duration of the PDT effect was significantly longer in the PCV group than in the tAMD group.

Conclusions: PDT may have some advantages for PCV patients, but not for tAMD patients. However, as PCV often recurred 12 months post-PDT, long-term observation after the treatment is crucial.