Intravitreal ranibizumab combined with verteporfin photodynamic therapy for treating polypoidal choroidal vasculopathy

Abstract

Purpose: To evaluate the efficacy of intravitreal ranibizumab (Lucentis) with verteporfin photodynamic therapy for patients with polypoidal choroidal vasculopathy.

Methods: Retrospective interventional case series. Seventeen eyes of 17 patients with symptomatic polypoidal choroidal vasculopathy who received 3 monthly intravitreal ranibizumab injections with photodynamic therapy were retrospectively reviewed. The follow-up period lasted for more than 6 months after therapy. Best-corrected visual acuity, foveal thickness determined by optical coherence tomography, and abnormal vasculature in indocyanine green angiography were evaluated.

Results: The mean follow-up period was 13.8 months. The mean logarithm of the minimum angle of resolution best-corrected visual acuity was 0.43 ± 0.36 at baseline, 0.14 ± 0.24 at 6 months (P = 0.01), and 0.11 ± 0.23 at 12 months after treatment (P = 0.02). The mean foveal height was 351 ± 111 μm at baseline, 192 ± 44 μm at 6 months (P = 0.02), and 204 ± 31 μm at 12 months after treatment (P = 0.01). Patients received a mean of 3.2 ranibizumab treatments and 1.3 verteporfin photodynamic therapy treatments over the follow-up period. Re-treatment was performed in 5 of 17 eyes. The polypoidal lesions on indocyanine green angiography were regressed in six eyes, reduced in seven eyes, and unchanged in four eyes.

Conclusion: Intravitreal ranibizumab with photodynamic therapy may stabilize visual acuity and reduce exudative retinal detachment because of decreased vascular leaking. The combination treatment appeared to be useful for regressing polypoidal lesions on indocyanine green angiography and in reducing their recurrence.