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Photodynamic therapy with verteporfin in polypoidal choroidal vasculopathy: results after 3 years of follow-up.

Author(s): Leal S, Silva R, Figueira J, Cachulo ML, Pires I, de Abreu JR, Cunha-Vaz JG

Affiliation(s): Department of Ophthalmology, University Hospital of Coimbra, Coimbra, Portugal. sergiosilvaleal@gmail.com

Publication date & source: 2010-09, Retina., 30(8):1197-205.

PURPOSE: The purpose of this study was to evaluate the efficacy of verteporfin photodynamic therapy on the treatment of polypoidal choroidal vasculopathy. METHODS: A prospective, nonrandomized institutional study was conducted involving 42 eyes of 38 patients with newly diagnosed symptomatic polypoidal choroidal vasculopathy treated exclusively with photodynamic therapy. Twenty-seven eyes completed 3 years of follow-up. Subjects were observed every 3 months with evaluation of best-corrected visual acuity (BCVA), retinography, and fluorescein and indocyanine green angiography. Treatment was given whenever the patient exhibited subfoveal exudation on fluorescein angiography. RESULTS: Mean BCVA was 0.91 +/- 0.33 logarithm of the minimum angle of resolution on the initial visit and 0.93 +/- 0.39 on the 36-month visit. Patients were submitted to an average of 3.19 treatment sessions. On the final evaluation at 36 months, 14.8% of the treated eyes improved their BCVA by at least 0.3 logarithm of the minimum angle of resolution, 74.1% had no significant loss of BCVA, and 25.9% lost >or=0.3 logarithm of the minimum angle of resolution. Recurrences were frequent (59.3% of the eyes at 3 years of follow-up), responded well to retreatment, and were not associated with additional BCVA loss. CONCLUSION: Photodynamic therapy remains a good option for management of polypoidal choroidal vasculopathy. After 3 years, approximately three fourths of the treated eyes had no significant loss of vision, and 14.8% showed significant improvement in visual acuity.

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