Short-term efficacy and predictors of recurrence of initial photodynamic therapy with anti-vascular endothelial growth factor injections for polypoidal choroidal vasculopathy

Purpose : To report the short-term efficacy and predictors of recurrence of initial photodynamic therapy (PDT) with anti-vascular endothelial growth factor (VEGF) injections for polypoidal choroidal vasculopathy (PCV) . Cases and method : This retrospective study included 14 eyes of 14 patients of PCV who were treated with PDT-combined therapy with intravitreal anti-VEGF drug injections between August 1, 2017 and August 1, 2018. The patients received PDT and anti-VEGF therapy over 3 times and were observed for 12 months after PDT. Recurrence was assessed based on new bleeding in the fundus and the presence of exudative changes observed in spectral-domain optical coherent tomography. We assessed the efficacy of the PDT-combined therapy by visual acuity, central retinal thickness (CRT), and central choroidal thickness (CCT) at 12 months after PDT therapy. We also studied the relationship between recurrence and baseline characteristics (patients characteristics, polyp type, visual acuity, CRT, CCT, greatest linear dimension and low fluorescence area in fundus autofluorescence (FAP)). Results ': The visual acuity improved or was maintained with the decrease of CRT and CCT in all patients 12 months after PDT therapy. Four eyes (29%) in 14 eyes showed recurrence during the observation period. Patients' characteristics, polyp type, visual acuity, CRT and greatest linear dimension had no correlation with the recurrence. However, the recurrence group showed thinner CCT (The average CCT was 279*59 ßm in non-recurrence group, 196 ± 5 0 / i m in recurrence group. p<0.05) and larger low fluorescence area in FAF (The average low fluorescence area in FAF was 3.2 ± 1 . 9 //m² in non-recurrence group, 9.1 ± 5 - 3 ßm² in recurrence group. p<0.05) before therapy compared with non-recurrence group. Conclusion ': PDT-combined therapy was effective to maintain the visual acuity with subfoveal exudative improvement in PCV patients one year after the therapy. The thin subfoveal choroidal thickness and the large low fluorescence area in FAF at baseline could be risk factors for the recurrence after the PDT-combined therapy for PCV.