One-year efficacy of “rescue photodynamic therapy” for patients with typical age-related macular degeneration, polypoidal choroidal vasculopathy, and pachychoroid neovasculopathy refractory to anti-vascular endothelial growth factor therapy

Iori Wada, Satomi Shiose, Keijiro Ishikawa, Kumiko Kano, Shoji Notomi, Kenichiro Mori, Masato Akiyama, Shintaro Nakao, Koh Hei Sonoda

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: This study aimed to evaluate the one-year outcomes of photodynamic therapy (PDT) as a rescue treatment for age-related macular degeneration (AMD) refractory to anti-vascular endothelial growth factor (VEGF) therapy. Methods: Patients with AMD refractory to anti-VEGF therapy, treated with “rescue-PDT” were retrospectively investigated. The time of PDT was defined as the baseline value. Baseline characteristics including sex, age, best-corrected visual acuity (BCVA), central macular thickness (CMT), and foveal choroidal thickness (FCT) were examined. The changes in BCVA, CMT, and recurrence were also assessed at the 1-year follow-up. The logMAR VA change of 0.3 or more was defined as “improved” or “declined.” Results: Twenty-three consecutive eyes (typical AMD: 10 eyes, polypoidal choroidal vasculopathy: 10 eyes, and pachychoroid neovasculopathy: 3 eyes), which underwent “rescue-PDT,” were analyzed in this study. The BCVA was improved in three patients and maintained in 20 patients at 12 months after PDT (mean BCVA change: 0.11 ± 0.19). The CMT improved in 19 patients (82.6%), and the mean CMT changed from 318.5 ± 93.7 μm to 225.9 ± 51.6 μm (p < 0.01) 12 months after PDT. “Retreatment” of anti-VEGF drug injections was considered if the retinal fluid or retinal hemorrhage recurred after PDT. The baseline FCT of the “retreatment group (15 eyes)” was significantly lower than that of the “no retreatment group (8 eyes)” (206.3 ± 50.7 μm vs 293.9 ± 85.7 μm: p = 0.033). Conclusions: PDT could be an effective treatment option for anti-VEGF refractory AMD to maintain visual acuity and control retinal fluid for up to 12 months.

Original languageEnglish
Pages (from-to)2029-2036
Number of pages8
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Volume260
Issue number6
DOIs
Publication statusPublished - Jun 2022

All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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