Objective To determine the efficacy of photodynamic ther-apy(PDT)with verteporfin as a treatment for s ymptomatic polypoidal choroidal vasculopathy(PCV).Design Prospective consecutive,2-centered,noncomparative in-terv...Objective To determine the efficacy of photodynamic ther-apy(PDT)with verteporfin as a treatment for s ymptomatic polypoidal choroidal vasculopathy(PCV).Design Prospective consecutive,2-centered,noncomparative in-terventional case series.Particip ants Twenty-one Asian patients with 22eyes presenting with serosanguinous maculopathy due to PCV and an initial best-corrected vi-sual acuity(BCVA)of 20/40or worse were recruited prospectively.All patients had angiographic leakage seen on fluorescein angiograms (FAs )and features of PCVseen with indocyanine green(ICG)angiography.Methods In-travenous infusion of verteporfin a t a dose of 6mg /m 2 of body surface area over 10minutes was administered.Five minutes after the completion of infu sion,a 689-nm laser was applied for 83seconds,with a lig ht dose of 50J /cm 2 .The laser spot size was chosen to cover the polyps and the surrounding abnormally dilated choroidal vessels shown on ICG angiography plus an extra 1000-μm margin.Photo-dynamic therapy retreatment was performed if leakage from the polyps was found on both repeat FA s and ICG an-giography at regular 3-month follow-up intervals.Main outcome measures The proportion of e yes with stable or improved vision at a 1-year follow-u p.Secondary outcome measures included change in mean BCV A and the changes in clinical and angiographic featur es in FAs and ICG an-giography.The total number of PDT se ssions and any complications were also recorded.R esults Stable or im-proved vision was achieved in 21(95%)of the 22eyes at the 1-year follow-up.Ten(45%)eyes had a moderate gain in vision(improved by≥3lines),whereas 1(5%)eye suffered a moderate visual loss(decrease by≥3lines).The mean BCVA improved from a logarithm of the minimum angle of resolution(logMAR)of 0.73to 0.60,an equivalent of 1.3lines of improvement.The change in logMAR BCVA at 12months was statisti cally significant (Wilcoxon signed-ranks test,P=0.009).Complete ab-sence of leakage in FAs and total regression of the polyps in ICG angiography were observed in 20(91%)and 21(95%)eyes,respectively.Severe loss of v ision due to massive subretinal hemorrhage occu rred in 1eye;other-wise,there were no other serious tre atment-related adverse events.Conclusions The 1-year resu lts of PDT in treating PCV of the macular type with serosanguinous presentations are encouraging.Further studies wi th longer follow-up and randomized controlled trials are wa rranted to assess the long-term safety and efficacy of PDT relative to observation or other treatment modalities.展开更多
文摘Objective To determine the efficacy of photodynamic ther-apy(PDT)with verteporfin as a treatment for s ymptomatic polypoidal choroidal vasculopathy(PCV).Design Prospective consecutive,2-centered,noncomparative in-terventional case series.Particip ants Twenty-one Asian patients with 22eyes presenting with serosanguinous maculopathy due to PCV and an initial best-corrected vi-sual acuity(BCVA)of 20/40or worse were recruited prospectively.All patients had angiographic leakage seen on fluorescein angiograms (FAs )and features of PCVseen with indocyanine green(ICG)angiography.Methods In-travenous infusion of verteporfin a t a dose of 6mg /m 2 of body surface area over 10minutes was administered.Five minutes after the completion of infu sion,a 689-nm laser was applied for 83seconds,with a lig ht dose of 50J /cm 2 .The laser spot size was chosen to cover the polyps and the surrounding abnormally dilated choroidal vessels shown on ICG angiography plus an extra 1000-μm margin.Photo-dynamic therapy retreatment was performed if leakage from the polyps was found on both repeat FA s and ICG an-giography at regular 3-month follow-up intervals.Main outcome measures The proportion of e yes with stable or improved vision at a 1-year follow-u p.Secondary outcome measures included change in mean BCV A and the changes in clinical and angiographic featur es in FAs and ICG an-giography.The total number of PDT se ssions and any complications were also recorded.R esults Stable or im-proved vision was achieved in 21(95%)of the 22eyes at the 1-year follow-up.Ten(45%)eyes had a moderate gain in vision(improved by≥3lines),whereas 1(5%)eye suffered a moderate visual loss(decrease by≥3lines).The mean BCVA improved from a logarithm of the minimum angle of resolution(logMAR)of 0.73to 0.60,an equivalent of 1.3lines of improvement.The change in logMAR BCVA at 12months was statisti cally significant (Wilcoxon signed-ranks test,P=0.009).Complete ab-sence of leakage in FAs and total regression of the polyps in ICG angiography were observed in 20(91%)and 21(95%)eyes,respectively.Severe loss of v ision due to massive subretinal hemorrhage occu rred in 1eye;other-wise,there were no other serious tre atment-related adverse events.Conclusions The 1-year resu lts of PDT in treating PCV of the macular type with serosanguinous presentations are encouraging.Further studies wi th longer follow-up and randomized controlled trials are wa rranted to assess the long-term safety and efficacy of PDT relative to observation or other treatment modalities.
