Impact of photodynamic therapy combined with Anti-VEGF vs. Anti-VEGF monotherapy on choriocapillaris vessel density in polypoidal choroidal vasculopathy

• Published in: Photodiagnosis and photodynamic therapy Vol. 52; p. 104531
• Main Authors: Kuo, Po-Chin, Hsu, Sheng-Min, Huang, Yi-Hsun, Chang, Chun-Hsiang, Chang, Yi-Sheng, Hung, Jia-Horung, Lai, Chun-Chieh, Lee, Yu-Kuei
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.04.2025; Elsevier
• Subjects: Aged; Angiogenesis Inhibitors - administration & dosage; Angiogenesis Inhibitors - therapeutic use; Anti-VEGF; Choriocapillaris vessel density; Choroid - blood supply; Choroidal Neovascularization - drug therapy; Female; Fluorescein Angiography; Humans; Intravitreal Injections; Male; Middle Aged; Optical coherence tomography angiography; Photochemotherapy - methods; Photodynamic therapy; Photosensitizing Agents - therapeutic use; Polypoidal Choroidal Vasculopathy; Ranibizumab - administration & dosage; Ranibizumab - therapeutic use; Receptors, Vascular Endothelial Growth Factor - administration & dosage; Receptors, Vascular Endothelial Growth Factor - therapeutic use; Recombinant Fusion Proteins - administration & dosage; Recombinant Fusion Proteins - therapeutic use; Retrospective Studies; Tomography, Optical Coherence; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity - drug effects; Polypoidal choroidal vasculopathy; Choriocapillaris vessel density; Anti-VEGF; Photodynamic therapy; Optical coherence tomography angiography
• ISSN: 1572-1000; 1873-1597; 1873-1597
• DOI: 10.1016/j.pdpdt.2025.104531

•PCV contributes to up to 50 % of nAMD cases in Asia.•Using OCTA, PDT plus IVR vs. IVA monotherapy showed similar VA and CMT in PCV.•Notably, PDT with anti-VEGF reduced choriocapillaris vessel density in PCV. To compare the choriocapillaris vessel density between intravitreal ranibizumab (Lucentis) (IVR) plus photodynamic therapy (PDT) and intravitreal aflibercept (Eylea) (IVA) monotherapy in patients experiencing polypoidal choroidal vasculopathy (PCV). An observational, retrospective cohort study. Adults with treatment-naïve PCV. IVR plus PDT or IVA monotherapy. After propensity-score (PS) matching, study outcomes were compared at 1 month after the final treatment. The primary outcome was a choriocapillaris vessel density, recognized by optical coherence tomography angiography (OCTA). The secondary outcomes included best corrected visual acuity (BCVA), presence of retinal hemorrhage, central macular thickness (CMT) and subfoveal choroidal thickness (SFCT), assessed by optical coherence tomography (OCT). Initially, 23 patients receiving IVR plus PDT, and 75 patients receiving IVA monotherapy were included. After PS-matching, 19 eyes of 19 patients receiving IVR plus PDT and 38 eyes of 38 patients receiving IVA monotherapy were analyzed. A significantly lower choriocapillaris vessel density in the IVR plus PDT group than the IVA monotherapy group (41.9 % vs. 52.2 %, p = 0.009) was demonstrated. The similarity of the BCVA, occurrence and severity of retinal hemorrhage, CMT, and SFCT between two treatment groups was exhibited. The choriocapillaris vessel density was significantly reduced in PCV patients treated with IVR plus PDT compared to those receiving IVA monotherapy.