Two-Year Results of Photodynamic Therapy With or Without Intravitreal Ranibizumab for Polypoidal Choroidal Vasculopathy

Purpose: To compare the 2-year outcomes of photodynamic therapy (PDT) with or without intravitreal ranibizumab (IVR) for polypoidal choroidal vasculopathy (PCV). Methods: Medical charts from 58 patients with PCV, who had been followed up for more than 2 years after initial treatment, were reviewed retrospectively. Visual outcomes were compared between 2 groups, consisting of 34 patients treated with PDT monotherapy without IVR and 24 with the combination of PDT and IVR, and the factors associated with the 2-year visual outcomes were investigated using multiple regression analysis. Results: In the PDT monotherapy group, the logarithm of the minimum angle of resolution (logMAR) of the best-corrected visual acuity (BCVA) improved significantly at 12 months (P=0.026), but was not significantly different from the initial logMAR BCVA at 24 months (P=0.21). By contrast, the logMAR BCVA improved significantly at 12 months and was maintained throughout the second 12-month period (P<0.001 at all time points) in the combined PDT group. Multiple regression analysis revealed that the initial BCVA (P<0.001), the greatest linear dimension of the initial PDT (P=0.006), and the combined PDT (P=0.039) were predictors of visual outcomes at 24 months. Conclusions: Combined PDT with IVR is a better treatment modality compared with PDT monotherapy, and results in improvement of visual outcomes at 24 months after the initial treatment.