RESEARCH ARTICLE


Photodynamic and Anti-VEGF Therapy for Polypoidal Choroidal Vasculopathy - ‘Real World’ Outcomes in a Caucasian Population



Kenneth M. Gilmour1, *, David Young2, Aaron Jamison1, Monica Precup1, David F. Gilmour1
1 Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow. G12 0YN, UK
2 Department of Mathematics and Statistics, NHS, Greater Glasgow and Clyde, University of Strathclyde, 16 Richmond Street Glasgow, G1 1XQ, UK


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Creative Commons License
© 2023 Gilmour et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow. G12 0YN, UK; Tel: 01236 590882; E-mail: Kenneth.gilmour@ggc.scot.nhs.uk


Abstract

Background:

The prevalence of polypoidal choroidal vasculopathy (PCV) is significantly higher amongst Asian populations compared to Caucasian, and evidence regarding the clinical outcomes of Caucasian patients is limited.

Objective:

This retrospective study sought to investigate real-world clinical outcomes of Caucasian PCV patients treated with polypoidal verteporfin photodynamic therapy (PDT) in combination with anti-VEGF therapy up to 36 months post-treatment.

Methods:

Consecutive PCV patients who received PDT between 2011 and 2017 were included. Mean change in visual acuity (VA) measured by ETDRS letter score and mean change in central subfield thickness (CST) were the main outcome measures. Data were collected at baseline, 3, 12, 24 and 36 months. Regression analyses were carried out on pre-treatment clinical features to determine if there were any factors associated with a good visual outcome (better than or equal to 70 ETDRS letters at 12 months).

Results:

Seventy six patients (96% Caucasian) and seventy eight eyes were included in the analysis. Mean change in VA was -1, -4, and 0 ETDRS letters at 12, 24, and 36 months, respectively. CST was reduced by a mean of -51, -54, and -55 microns at 12, 24, and 36 months, respectively. Better pre-treatment VA was the only pre-treatment clinical feature associated with a good visual outcome at 12 months (OR 1.16, p<0.001).

Conclusion:

PDT, in combination with anti-VEGF therapy, maintains VA and may reduce the anti-VEGF therapy burden in Caucasian patients with PCV. Better pre-treatment VA is associated with a good visual outcome.

Keywords: Anti-VEGF, Caucasian, Polypoidal choroidal vasculopathy, Photodynamic therapy, Real-world outcomes, Therapy.