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Reduced-fluence PDT may benefit treatment-naïve patients with polypoidal choroidal vasculopathy

Am J Ophthalmol. 2009;doi:10.1016/j.ajo.2009.09.020

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Reduced-fluence photodynamic therapy stops leakage in patients with polypoidal choroidal vasculopathy and could help improve visual acuity, especially for eyes with better vision at baseline.

In a prospective interventional case series of 28 eyes of 28 treatment-naïve patients who underwent PDT with a fluence of 25 J/cm², mean best corrected visual acuity improved from 0.45 logMAR at baseline to 0.29 logMAR at 12 months. In 10 eyes with visual acuity of 20/40 or better at baseline, BCVA improved from 0.17 logMAR to 0.05 logMAR at 12 months.

In the study, 16 of 28 eyes had mild to moderate nonperfusion of choriocapillaris at 1 week, but 27 of 28 eyes recovered to baseline at 3 months. Minimal subretinal hemorrhage was noted in six eyes, but there was no vision loss greater than or equal to three lines, the study authors said.

Re-treatment was performed based on the presence of leakage on optical coherence tomography. During the study, the mean number of treatments per patient was 1.3, and 21 eyes required only a single treatment.