Initial Versus Delayed Photodynamic Therapy in Combination with Ranibizumab for Treatment of Polypoidal Choroidal Vasculopathy

On Behalf of the Fujisan Study Group

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Purpose: To compare the 1-year results of initial or deferred photodynamic therapy (PDT) combined with intravitreal ranibizumab (IVR) for eyes with polypoidal choroidal vasculopathy. Methods: Prospectively, 72 men with treatment-naive polypoidal choroidal vasculopathy were randomized to initial or later PDT combined with IVR. In both groups, 2 additional monthly IVR followed. From Month 3, PDT and IVR were administered according to the retreatment criteria. Mean changes in the best-corrected visual acuity between baseline and Month 12 and central retinal thickness, the rate of eyes showing regression of polypoidal lesions, and number of additional treatments were compared. Results: The best-corrected visual acuity increased by a mean of 8.1 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters in the initial PDT group and 8.8 ETDRS letters in the later PDT group, and there was a no significant difference (P 0.59). The mean central retinal thickness decreased significantly in both groups but more so with combination therapy within the first 4 months; the difference was not significant at Month 12 (P 0.30). The rate of eyes showing resolution of polypoidal lesions at 12 months was 62.1% in the initial PDT group and 54.8% in the later PDT group and again, there was no significant difference (P 0.53). The mean number of additional IVR was 1.5 in initial PDT and 3.8 in later PDT; that of additional PDTs was 0.14 and 0.45, respectively, and they were significantly different (P < 0.001 and P 0.013, respectively). Conclusion: Both initial and deferred PDT combined with IVR to treat polypoidal choroidal vasculopathy show the similar visual and anatomical improvements at 12 months. Initial PDT combination leads to significantly fewer additional treatments.

Original languageEnglish
Pages (from-to)1569-1576
Number of pages8
JournalRetina
Volume35
Issue number8
DOIs
Publication statusPublished - Aug 7 2015

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Photochemotherapy
Therapeutics
Diabetic Retinopathy
Visual Acuity
Ranibizumab
Retreatment

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Initial Versus Delayed Photodynamic Therapy in Combination with Ranibizumab for Treatment of Polypoidal Choroidal Vasculopathy. / On Behalf of the Fujisan Study Group.

In: Retina, Vol. 35, No. 8, 07.08.2015, p. 1569-1576.

Research output: Contribution to journalArticle

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title = "Initial Versus Delayed Photodynamic Therapy in Combination with Ranibizumab for Treatment of Polypoidal Choroidal Vasculopathy",
abstract = "Purpose: To compare the 1-year results of initial or deferred photodynamic therapy (PDT) combined with intravitreal ranibizumab (IVR) for eyes with polypoidal choroidal vasculopathy. Methods: Prospectively, 72 men with treatment-naive polypoidal choroidal vasculopathy were randomized to initial or later PDT combined with IVR. In both groups, 2 additional monthly IVR followed. From Month 3, PDT and IVR were administered according to the retreatment criteria. Mean changes in the best-corrected visual acuity between baseline and Month 12 and central retinal thickness, the rate of eyes showing regression of polypoidal lesions, and number of additional treatments were compared. Results: The best-corrected visual acuity increased by a mean of 8.1 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters in the initial PDT group and 8.8 ETDRS letters in the later PDT group, and there was a no significant difference (P 0.59). The mean central retinal thickness decreased significantly in both groups but more so with combination therapy within the first 4 months; the difference was not significant at Month 12 (P 0.30). The rate of eyes showing resolution of polypoidal lesions at 12 months was 62.1{\%} in the initial PDT group and 54.8{\%} in the later PDT group and again, there was no significant difference (P 0.53). The mean number of additional IVR was 1.5 in initial PDT and 3.8 in later PDT; that of additional PDTs was 0.14 and 0.45, respectively, and they were significantly different (P < 0.001 and P 0.013, respectively). Conclusion: Both initial and deferred PDT combined with IVR to treat polypoidal choroidal vasculopathy show the similar visual and anatomical improvements at 12 months. Initial PDT combination leads to significantly fewer additional treatments.",
author = "{On Behalf of the Fujisan Study Group} and Fumi Gomi and Yuji Oshima and Ryusaburo Mori and Mariko Kano and Masaaki Saito and Ayana Yamashita and Eiji Iwata and Ruka Maruko and Tomohiro Iida and Fumio Shiraga and Mitsuko Yuzawa and Hiroko Terasaki and Tatsuro Ishibashi and Chieko Shiragami and Yukari Shirakata and Chikako Hara and Miki Sawa and Kanji Takahashi",
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T1 - Initial Versus Delayed Photodynamic Therapy in Combination with Ranibizumab for Treatment of Polypoidal Choroidal Vasculopathy

AU - On Behalf of the Fujisan Study Group

AU - Gomi, Fumi

AU - Oshima, Yuji

AU - Mori, Ryusaburo

AU - Kano, Mariko

AU - Saito, Masaaki

AU - Yamashita, Ayana

AU - Iwata, Eiji

AU - Maruko, Ruka

AU - Iida, Tomohiro

AU - Shiraga, Fumio

AU - Yuzawa, Mitsuko

AU - Terasaki, Hiroko

AU - Ishibashi, Tatsuro

AU - Shiragami, Chieko

AU - Shirakata, Yukari

AU - Hara, Chikako

AU - Sawa, Miki

AU - Takahashi, Kanji

PY - 2015/8/7

Y1 - 2015/8/7

N2 - Purpose: To compare the 1-year results of initial or deferred photodynamic therapy (PDT) combined with intravitreal ranibizumab (IVR) for eyes with polypoidal choroidal vasculopathy. Methods: Prospectively, 72 men with treatment-naive polypoidal choroidal vasculopathy were randomized to initial or later PDT combined with IVR. In both groups, 2 additional monthly IVR followed. From Month 3, PDT and IVR were administered according to the retreatment criteria. Mean changes in the best-corrected visual acuity between baseline and Month 12 and central retinal thickness, the rate of eyes showing regression of polypoidal lesions, and number of additional treatments were compared. Results: The best-corrected visual acuity increased by a mean of 8.1 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters in the initial PDT group and 8.8 ETDRS letters in the later PDT group, and there was a no significant difference (P 0.59). The mean central retinal thickness decreased significantly in both groups but more so with combination therapy within the first 4 months; the difference was not significant at Month 12 (P 0.30). The rate of eyes showing resolution of polypoidal lesions at 12 months was 62.1% in the initial PDT group and 54.8% in the later PDT group and again, there was no significant difference (P 0.53). The mean number of additional IVR was 1.5 in initial PDT and 3.8 in later PDT; that of additional PDTs was 0.14 and 0.45, respectively, and they were significantly different (P < 0.001 and P 0.013, respectively). Conclusion: Both initial and deferred PDT combined with IVR to treat polypoidal choroidal vasculopathy show the similar visual and anatomical improvements at 12 months. Initial PDT combination leads to significantly fewer additional treatments.

AB - Purpose: To compare the 1-year results of initial or deferred photodynamic therapy (PDT) combined with intravitreal ranibizumab (IVR) for eyes with polypoidal choroidal vasculopathy. Methods: Prospectively, 72 men with treatment-naive polypoidal choroidal vasculopathy were randomized to initial or later PDT combined with IVR. In both groups, 2 additional monthly IVR followed. From Month 3, PDT and IVR were administered according to the retreatment criteria. Mean changes in the best-corrected visual acuity between baseline and Month 12 and central retinal thickness, the rate of eyes showing regression of polypoidal lesions, and number of additional treatments were compared. Results: The best-corrected visual acuity increased by a mean of 8.1 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters in the initial PDT group and 8.8 ETDRS letters in the later PDT group, and there was a no significant difference (P 0.59). The mean central retinal thickness decreased significantly in both groups but more so with combination therapy within the first 4 months; the difference was not significant at Month 12 (P 0.30). The rate of eyes showing resolution of polypoidal lesions at 12 months was 62.1% in the initial PDT group and 54.8% in the later PDT group and again, there was no significant difference (P 0.53). The mean number of additional IVR was 1.5 in initial PDT and 3.8 in later PDT; that of additional PDTs was 0.14 and 0.45, respectively, and they were significantly different (P < 0.001 and P 0.013, respectively). Conclusion: Both initial and deferred PDT combined with IVR to treat polypoidal choroidal vasculopathy show the similar visual and anatomical improvements at 12 months. Initial PDT combination leads to significantly fewer additional treatments.

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DO - 10.1097/IAE.0000000000000526

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