Efficacy of combined photodynamic therapy and intravitreal bevacizumab injection versus photodynamic therapy alone in polypoidal choroidal vasculopathy.

PURPOSE: To compare the efficacy of combined photodynamic therapy (PDT) and optical coherence tomography-guided intravitreal bevacizumab injection versus PDT alone for the treatment of polypoidal choroidal vasculopathy.

METHODS: The medical records of 39 patients with symptomatic polypoidal choroidal vasculopathy who received combination therapy with PDT and intravitreal bevacizumab injections or PDT monotherapy were retrospectively reviewed. Best-corrected visual acuity, number of treatments, and optical coherence tomography and angiographic findings were compared between the two patient groups.

RESULTS: In the PDT monotherapy group (n = 19), the mean number of PDTs was 1.89, whereas in the combined therapy group (n = 20), mean 1.30 times of PDT and 2.90 times of intravitreal bevacizumab injection were performed during the 12 months of follow-up. The number of PDTs was significantly different between the 2 groups (P = 0.032). At 12 months, the mean improvement in best-corrected visual acuity was 3.0 lines in the combined group and 1.6 lines in the PDT monotherapy group. At 12 months, improved vision by ≥ 3 lines was achieved in 55.0% in the combined therapy group and 36.8% in the PDT monotherapy group.

CONCLUSION: Combined PDT and bevacizumab therapy effectively treated polypoidal choroidal vasculopathy with fewer PDTs compared with PDT alone during the 1 year of follow-up. Combined treatment appeared to result in better visual acuity, but a larger scale study is required to draw a definite conclusion.