Photodiagnosis and photodynamic therapy · 2021
Long-term prognosis of polypoidal choroidal vasculopathy with a 5-year remission after an initial combination therapy.
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Kikushima Wataru, Sakurada Yoichi, Yoneyama Seigo, Sugiyama Atsushi, Matsubara Mio, Fukuda Yoshiko, Kashiwagi Kenji
Аннотация
PURPOSE: To investigate the visual prognosis of patients with polypoidal choroidal vasculopathy (PCV) with a 5-year remission after an initial combination therapy involving photodynamic therapy (PDT) and intravitreal ranibizumab (IVR) or aflibercept injection (IVA).
METHODS: Medical records of 69 consecutive patients with PCV treated with PDT with IVR/IVA were retrospectively reviewed, and 17 eyes were identified with a 5-year remission after the initial combination therapy. The eyes that did not require additional treatment during the 1st-5th year were assigned to the remission group and the eyes requiring additional treatment during the 1st-5th year were assigned to the recurrence group.
RESULTS: During the 7-year follow-up, the mean logarithm of the minimal angle resolution best-corrected visual acuity (logMAR BCVA) significantly improved from 0.39±0.27 to 0.17±0.38 (p=2.9 × 10-4) in the remission group, whereas the mean logMAR BCVA was maintained throughout the follow-up period (0.58±0.27 to 0.60±0.48) in the recurrence group. In the remission group, only two (11.8%) of the 17 eyes experienced recurrence during the 5th-7th year. Comparison of baseline characteristics between the two groups revealed that a higher proportion of female (p=0.012), better baseline BCVA (p=3.1 × 10-3), and lower risk allele frequency in ARMS2 A69S (p=0.029) were observed in the remission group.
CONCLUSIONS: The combination therapy showed a favourable outcome for PCV over a 7-year follow-up, especially in the eyes without recurrence during the 1st-5th year. Physicians should be careful of recurrent exudation in the eyes without recurrence during the 1st-5th years, although the recurrence rate was low.
METHODS: Medical records of 69 consecutive patients with PCV treated with PDT with IVR/IVA were retrospectively reviewed, and 17 eyes were identified with a 5-year remission after the initial combination therapy. The eyes that did not require additional treatment during the 1st-5th year were assigned to the remission group and the eyes requiring additional treatment during the 1st-5th year were assigned to the recurrence group.
RESULTS: During the 7-year follow-up, the mean logarithm of the minimal angle resolution best-corrected visual acuity (logMAR BCVA) significantly improved from 0.39±0.27 to 0.17±0.38 (p=2.9 × 10-4) in the remission group, whereas the mean logMAR BCVA was maintained throughout the follow-up period (0.58±0.27 to 0.60±0.48) in the recurrence group. In the remission group, only two (11.8%) of the 17 eyes experienced recurrence during the 5th-7th year. Comparison of baseline characteristics between the two groups revealed that a higher proportion of female (p=0.012), better baseline BCVA (p=3.1 × 10-3), and lower risk allele frequency in ARMS2 A69S (p=0.029) were observed in the remission group.
CONCLUSIONS: The combination therapy showed a favourable outcome for PCV over a 7-year follow-up, especially in the eyes without recurrence during the 1st-5th year. Physicians should be careful of recurrent exudation in the eyes without recurrence during the 1st-5th years, although the recurrence rate was low.