Mun-Wai Lee, MD (Singapore, Singapore), Doric Wong, FRCS(Ed) (Singapore, Singapore)

PURPOSE:

To describe the efficacy of photodynamic therapy (PDT) in the treatment of idiopathic polypoidal choroidal vasculopathy (IPCV).

METHODS:

Retrospective analysis of a consecutive series of patients who presented with symptomatic serosanguineous maculopathy secondary to IPCV. All patients had indocyanine green defined lesions and underwent PDT with verteporfin. Patients had pre-treatment best corrected visual acuity (BCVA) measured and were followed up at 3, 6, 9 and 12 months after PDT with BCVA recorded at each visit. Snellen acuity was converted to logarithm of minimal angle of resolution (logMAR) for the purposes of analysis. The main outcome measures were the BCVA after 12 months follow-up and clinical or angiographic  evidence showing resolution of serosanguineous maculopathy.

RESULTS:

45 eyes of 44 patients completed 12 months follow-up. 6 of 11 eyes (54.5%) with juxtafoveal lesions and 26 of 34 eyes (76.5%) with subfoveal lesions had stable or improved vision (loss of less than 0.3 logMAR units) at 12 months. In these 32 eyes, the mean BCVA before treatment and at 12 months follow-up were 0.75(range 0.02-2.00) and 0.48 (range 0-2.00)
respectively. The mean number of treatments was 1.95. 37 eyes (82.2%) had dry, quiescent scars at 12 months, 5 eyes (11.1%) had persistent leakage and 3 eyes (6.7%) had evidence of choroidal neovascularisation.

CONCLUSION:

These results indicate that PDT does offer some benefit for patients with serosanguineous maculopathy secondary to IPCV. However, in view of the retrospective nature of this study, small sample size and lack of control group for comparison, the true efficacy of PDT for IPCV would have to be evaluated with a larger, randomized controlled trial.