Purpose: Indications for photodynamic therapy (PDT) have increased from age-related macular degeneration with choroidal neovascularization (CNV), containing more than 50% of the classic component, to occult CNV, myopic CNV and CNV due to ocular histoplasmosis syndrome. In the present study, the effect of PDT with verteporfin was examined in polypoidal choroidal vasculopathy (PCV) of the macula. Methods: PDT was performed in 9 eyes with PCV of the macula. Fundus examination, fluorescein angiography, and indocyanine green angiography were performed before PDT and 3 months after PDT in all eyes. Optical coherence tomography was performed in 6 eyes. Results: After the initial PDT, visual acuity was stabilized or improved in 8 eyes (89%), polypoid elements were obliterated in 7 eyes (78%), and vascular nets were reduced in 8 eyes (89%). Of 6 eyes that received optical coherence tomography, pigment epithelium detachment was reduced or disappeared in all eyes except 1, which developed a disciform scar. An additional PDT was performed in 4 eyes to decrease vascular leakage. During the follow-up period of 3–18 months, no reactivation of PCV was observed. Conclusion: PDT offers an effective way of treating PCV of the macula, by obliterating polypoid elements of the PCV. However, long-term follow-up is needed.

Keywords:
Choroidal neovascularization, Photodynamic therapy, Polypoidal choroidal vasculopathy, Subretinal hemorrhage
1.
Yannuzzi LA, Sorenson J, Spaide RF, Lipson B: Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina 1990;10:1–8.
2.
Kleiner RC, Brucker AJ, Johnston RL: The posterior uveal bleeding syndrome. Retina 1990;10:9–17.
3.
Yannuzzi LA, Ciardella A, Spaide RF, Rabb M, Freund B, Orlock DA: The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy. Arch Ophthalmol 1997;115:478–485.
4.
Yannuzzi LA, Wong DWK, Sforzolini BS, Goldbaum M, Tang KC, Spaide RF, Freund KB, Slakter JS, Guyer DR, Sorenson JA, Fisher Y, Maberley D, Orlock DA: Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration. Arch Ophthalmol 1999;117:1503–1510.
5.
Schneider U, Gelisken F, Kreissig I: Indocyanine green angiography and idiopathic polypoidal choroidal vasculopathy. Br J Ophthalmol 1998;82:98–99.
6.
Uyama M, Matsubara T, Fukushima I, Matsunaga H, Iwashita K, Nagai Y, Takahashi K: Idiopathic polypoidal choroidal vasculopathy in Japanese patients. Arch Ophthalmol 1999;117:1035–1042.
7.
Iijima H, Imai M, Gohdo T, Tsukahara S: Optical coherence tomography of idiopathic polypoidal choroidal vasculopathy. Am J Ophthalmol 1999;127:301–305.
8.
Moorthy RS, Lyon AT, Rabb MF, Spaide RF, Yannuzzi LA, Jampol LM: Idiopathic polypoidal choroidal vasculopathy of the macula. Ophthalmology 1998;105:1380–1385.
9.
Yannuzzi LA, Nogueira FB, Spaide RF, Guyer DR, Orlock DA, Colombero D, Freund KB: Idiopathic polypoidal choroidal vasculopathy: A peripheral lesion. Arch Ophthalmol 1998;116:382–383.
10.
Uyama M, Wada M, Nagai Y, Matsubara T, Matsunaga H, Fukushima I, Takahashi K, Matsumura M: Polypoidal choroidal vasculopathy: Natural history. Am J Ophthalmol 2002;133:639–648.
11.
Yannuzzi LA, Freund KB, Goldbaum M, Sforzolini BS, Guyer DR, Spaide RF Maberley D, Wong DWK, Slakter JS, Sorenson JA, Fisher YL, Orlock DA: Polypoidal choroidal vasculopathy masquerading as central serous chorioretinopathy. Ophthalmology 2002;107:767–777.
12.
Lafaut BA, Leys AM, Snyers B, Rasquin F, De Laey JJ: Polypoidal choroidal vasculopathy in Caucasians. Graefe’s Arch Clin Exp Ophthalmol 2000;238:752–759.
13.
Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group: Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: Two-year results of 2 randomized clinical trials. TAP report 2. Arch Ophthalmol 2001;119:198–207.
14.
Verteporfin in Photodynamic Therapy (VIP) Study Group: Photodynamic therapy of subfoveal choroidal neovascularization in pathologic myopia with verteporfin: 1-year results of a randomized clinical trials. VIP report No. 1. Ophthalmology 2001;108:841–852.
15.
Saperstein DA, Rosenfeld PJ, Bressler NM, Rosa RH, Sickenberg M, Sternberg P Jr, Aaberg TM Sr, Aaberg TM Jr, Reaves TA: Photodynamic therapy of subfoveal choroidal neovascularization with verteporfin in the ocular histoplasmosis syndrome: One-year results of an uncontrolled, prospective case series. Ophthalmology 2002;109:1499–1505.
16.
Quaranta M, Mauget-Faysse M, Coscas G: Exudative idiopathic polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin. Am J Ophthalmol 2002;134:277–280.
17.
Spaide RF, Donsoff I, Lam DL, Yannuzzi LA, Jampol LM, Slakter J, Sorenson J, Freund KB: Treatment of polypoidal choroidal vasculopathy with photodynamic therapy. Retina 2002;22:529–535.
18.
Iijima H, Iida T, Imai M, Ghodo T, Tsukahara S: Optical coherence tomography of orange-red subretinal lesions in eyes with idiopathic polypoidal choroidal vasculopathy. Am J Ophthalmol 2000;129:21–26.
19.
Otsuji T, Takahashi K, Fukushima I, Uyama M: Optical coherence tomographic findings of idiopathic polypoidal choroidal vasculopathy. Ophthalmic Surg Lasers 2000;31:210–214.
20.
Schmidt-Erfurth U, Hasan T, Gragoudas E, Michaud N, Flotte TJ, Bringruber R: Vascular targeting in photodynamic occlusion of subretinal vessels. Ophthalmology 1994;101:1953–1961.
© 2004 S. Karger AG, Basel
2004
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.