COMBINED INTRAVITREAL RANIBIZUMAB AND PHOTODYNAMIC THERAPY FOR POLYPOIDAL CHOROIDAL VASCULOPATHY

Purpose: To clarify the efficacy of combined therapy with intravitreal ranibizumab injections and photodynamic therapy in patients with symptomatic polypoidal choroidal vasculopathy. Methods: We retrospectively reviewed 28 naive eyes of 28 patients (17 men, 11 women; mean age, 73.4 years; range, 55-85 years) with 20/40 or less baseline visual acuity treated with 3 consecutive monthly intravitreal injections of ranibizumab (0.5 mg/0.05 mL) and photodynamic therapy and followed-up for at least 12 months. Photodynamic therapy was administered 1 day or 2 days after the initial injection of ranibizumab. Results: The mean best-corrected visual acuity levels significantly (P < 0.0001) improved from 0.33 at baseline to 0.61 at 12 months. The mean improvement in best-corrected visual acuity 12 months from baseline was 2.65 lines. The best-corrected visual acuity at 12 months improved in 15 eyes (53.6%) by >= 3 lines and was stable (defined as a loss of <3 lines of vision) in 13 eyes (46.4%). The central retinal thickness significantly (P < 0.0001) decreased from 366 mu m to 151 mu m at 12 months. The mean numbers of photodynamic therapy treatments and injections during 12 months including the treatments during the initial regimen were 1.1 and 3.7, respectively. No complications developed. Conclusion: Combined intravitreal ranibizumab and photodynamic therapy for polypoidal choroidal vasculopathy maintained or improved visual acuity and reduced the exudation without adverse events. RETINA 32:1272-1279, 2012