To compare the short-term efficacy and safety of combination therapy with standard fluence and reduced fluence PDT in polypoidal choroidal vasculopathy

Abstract

  To evaluate and compare the efficacy of reduced-fluence photodynamic therapy (PDT) with standard-fluence photodynamic therapy in treating polypoidal choroidal vasculopathy.  Twenty-eight eyes (27 patients) with polypoidal choroidal vasculopathy were retrospectively analysed; 14 eyes received Indocyanine green angiography-guided standard-fluence (SF) PDT (50 J/cm) and 14 eyes received Indocyanine green angiography-guided reduced-fluence (RF) PDT (25 J/cm). Primary outcome measured after 6 months of treatment were the changes in mean BCVA, polyp regression, polyp PED height, central choroidal thickness (CCT), post PDT intravitreal anti VEGF injection need and complications. Results of both the groups were comparable at 6 months follow up. Mean change in log mar visual acuity at 6 months for the SF PDT group was 0.12 compared to 0.13 for the RF PDT group (p = 0.919).  Mean change in PED height at 6 months for the SF PDT group was 159 μm compared to 172 μm for the RF PDT group (p = 0.06). Mean change in CCT at 6 months for the SF PDT group was 45μm compared to 10μm for the RF PDT group (p = 0.96). While the SF PDT group needed a mean of 2 injections post PDT, the RF PDT group required a mean of 3 injections during the course of 6 months follow up. Neither of the group reported any adverse effects following the procedure. Our study demonstrated that reduced-fluence PDT is at least on par with standard-fluence PDT in management of PCV.