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PHOTODYNAMIC THERAPY WITH VERTEPORFIN IN POLYPOIDAL CHOROIDAL VASCULOPATHY: Results After 3 Years of Follow-Up

Purpose: The purpose of this study was to evaluate the efficacy of verteporfin photodynamic therapy on the treatment of polypoidal choroidal vasculopathy. Methods: A prospective, nonrandomized institutional study was conducted involving 42 eyes of 38 patients with newly diagnosed symptomatic polypoidal choroidal vasculopathy treated exclusively with photodynamic therapy. Twenty-seven eyes completed 3 years of follow-up. Subjects were observed every 3 months with evaluation of best-corrected visual acuity (BCVA), retinography, and fluorescein and indocyanine green angiography. Treatment was given whenever the patient exhibited subfoveal exudation on fluorescein angiography. Results: Mean BCVA was 0.91 ± 0.33 logarithm of the minimum angle of resolution on the initial visit and 0.93 ± 0.39 on the 36-month visit. Patients were submitted to an average of 3.19 treatment sessions. On the final evaluation at 36 months, 14.8% of the treated eyes improved their BCVA by at least 0.3 logarithm of the minimum angle of resolution, 74.1% had no significant loss of BCVA, and 25.9% lost ≥0.3 logarithm of the minimum angle of resolution. Recurrences were frequent (59.3% of the eyes at 3 years of follow-up), responded well to retreatment, and were not associated with additional BCVA loss. Conclusion: Photodynamic therapy remains a good option for management of polypoidal choroidal vasculopathy. After 3 years, approximately three fourths of the treated eyes had no significant loss of vision, and 14.8% showed significant improvement in visual acuity.