Photodynamic Therapy and Bevacizumab Combination for Polypoidal Choroidal Vasculopathy Refractory to Intravitreal Ranibizumab

INTRODUCTION: The present study is an evaluation of outcomes of photodynamic therapy (PDT) combined with intravitreal injections of bevacizumab for polypoidal choroidal vasculopathy (PCV) that was nonresponding to ranibizumab injections.
METHODS: This retrospective study included 37 eyes of 37 patients with PCV. Principal outcome measurements used were mean change in best corrected visual acuity (BCVA) and central macular thickness (CMT), and regression rate of polypoidal lesions.
RESULTS: Mean follow-up time was 11.8±7.2 months. Mean BCVA decreased significantly from 0.69±0.42 logMAR at base- line to 0.78±0.42 logMAR at final visit (p=0.01). BCVA improved in 9 (24.3%) eyes, decreased in 11 (29.7%), and remained stable in 17 (45.9%) eyes. Mean CMT decreased from 352.2 μm (range: 139-573 μm) at baseline to 318±117.1 μm (range: 136–585 μm) at final visit (p=0.26). Seventeen (45.9%) eyes achieved dry macula, defined as absence of intraretinal or subretinal fluid on optical coherence tomography at 6 months. In addition, 25 eyes (67.5%) showed complete regression of polypoidal lesions.
DISCUSSION AND CONCLUSION: PDT combined with bevacizumab may be beneficial in resolution of exudation in eyes refractory to ranibi- zumab injections. VA improvement may be obtained in limited number of eyes.