Top

Published in:

01-06-2020 | Angiography | Original Paper

Early changes of vascular lesions and responses to combined photodynamic therapy in patients with polypoidal choroidal vasculopathy

Authors: Kimiko Asano-Shimizu, Shotaro Asano, Hiroshi Murata, Keiko Azuma, Yoko Nomura, Tatsuya Inoue, Asako Ogawa, Ryo Asaoka, Ryo Obata

Published in: International Ophthalmology | Issue 6/2020

Abstract

Purpose

To evaluate early changes of vascular lesions and their associations with the early responses to combined photodynamic therapy (PDT) in eyes with polypoidal choroidal vasculopathy (PCV).

Methods

This study evaluated 19 eyes of 19 patients with PCV who underwent PDT combined with anti-vascular endothelial growth factor injections and were followed for 3 months. All subjects were examined 1 week and 1, 2, and 3 months after combined PDT. “Active” cases were defined as recurrence or persistence of serous retinal detachment or subretinal hemorrhage detected within 3 months. Branching vascular networks (BVNs) were evaluated by optical coherence tomography angiography (OCTA) and polyps by indocyanine-green angiography.

Results

In total, 16%, 58%, 84%, and 89% of eyes displayed BVNs 1 week, 1, 2, and 3 months after PDT, respectively. BVNs were detected significantly more often 1 month after PDT in the “active” group than “inactive” group (89% vs. 30%, p = 0.020). There were significantly higher overall proportions of BVNs detected by OCTA in the “active” group than “inactive” group (p = 0.0058).

Conclusion

In most cases, BVNs disappeared once and gradually appeared again within 3 months. Detecting BVNs using OCTA from early phases could be a helpful biomarker to assess the early responses to PDT in eyes with PCV.

Yannuzzi LA, Sorenson J, Spaide RF, Lipson B (2012) Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina 32(Suppl 1):1–8PubMed
Cheung CMG, Lai TYY, Ruamviboonsuk P, Chen SJ, Chen Y, Freund KB, Gomi F, Koh AH, Lee WK, Wong TY (2018) Polypoidal choroidal vasculopathy: definition, pathogenesis, diagnosis, and management. Ophthalmology 125(5):708–724. https://doi.org/10.1016/j.ophtha.2017.11.019 View ArticlePubMed
Wong CW, Yanagi Y, Lee WK, Ogura Y, Yeo I, Wong TY, Cheung CMG (2016) Age-related macular degeneration and polypoidal choroidal vasculopathy in Asians. Prog Retin Eye Res 53:107–139. https://doi.org/10.1016/j.preteyeres.2016.04.002 View ArticlePubMed
Sho K, Takahashi K, Yamada H, Wada M, Nagai Y, Otsuji T, Nishikawa M, Mitsuma Y, Yamazaki Y, Matsumura M, Uyama M (2003) Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics. Arch Ophthalmol 121(10):1392–1396. https://doi.org/10.1001/archopht.121.10.1392 View ArticlePubMed
Maruko I, Iida T, Saito M, Nagayama D, Saito K (2007) Clinical characteristics of exudative age-related macular degeneration in Japanese patients. Am J Ophthalmol 144(1):15–22. https://doi.org/10.1016/j.ajo.2007.03.047 View ArticlePubMed
Liu Y, Wen F, Huang S, Luo G, Yan H, Sun Z, Wu D (2007) Subtype lesions of neovascular age-related macular degeneration in Chinese patients. Graefes Arch Clin Exp Ophthalmol 245(10):1441–1445. https://doi.org/10.1007/s00417-007-0575-8 View ArticlePubMed
Byeon SH, Lee SC, Oh HS, Kim SS, Koh HJ, Kwon OW (2008) Incidence and clinical patterns of polypoidal choroidal vasculopathy in Korean patients. Jpn J Ophthalmol 52(1):57–62. https://doi.org/10.1007/s10384-007-0498-2 View ArticlePubMed
Lim TH, Laude A, Tan CS (2010) Polypoidal choroidal vasculopathy: an angiographic discussion. Eye (Lond) 24(3):483–490. https://doi.org/10.1038/eye.2009.323 View Article
Lai TY, Lee GK, Luk FO, Lam DS (2011) Intravitreal ranibizumab with or without photodynamic therapy for the treatment of symptomatic polypoidal choroidal vasculopathy. Retina 31(8):1581–1588. https://doi.org/10.1097/IAE.0b013e31820d3f3f View ArticlePubMed
Koh A, Lee WK, Chen LJ, Chen SJ, Hashad Y, Kim H, Lai TY, Pilz S, Ruamviboonsuk P, Tokaji E, Weisberger A, Lim TH (2012) EVEREST study: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina 32(8):1453–1464. https://doi.org/10.1097/IAE.0b013e31824f91e8 View ArticlePubMed
Koh A, Lai TYY, Takahashi K, Wong TY, Chen LJ, Ruamviboonsuk P, Tan CS, Feller C, Margaron P, Lim TH, Lee WK, group EIs, (2017) Efficacy and safety of ranibizumab with or without verteporfin photodynamic therapy for polypoidal choroidal vasculopathy: a randomized clinical trial. JAMA Ophthalmol 135(11):1206–1213. https://doi.org/10.1001/jamaophthalmol.2017.4030 View ArticlePubMedPubMed Central
Morimoto M, Matsumoto H, Mimura K, Akiyama H (2017) Two-year results of a treat-and-extend regimen with aflibercept for polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol 255(10):1891–1897. https://doi.org/10.1007/s00417-017-3718-6 View Article
Cho JH, Park YJ, Cho SC, Ryoo NK, Cho KH, Park SJ, Park KH, Woo SJ (2018) Posttreatment polyp regression and risk of massive submacular hemorrhage in eyes with polypoidal choroidal vasculopathy. Retina. https://doi.org/10.1097/IAE.0000000000002384 View ArticlePubMedPubMed Central
Lee WK, Lee PY, Lee SK (2008) Photodynamic therapy for polypoidal choroidal vasculopathy: vaso-occlusive effect on the branching vascular network and origin of recurrence. Jpn J Ophthalmol 52(2):108–115. https://doi.org/10.1007/s10384-007-0501-y View ArticlePubMed
Lee WK, Kim KS, Kim W, Lee SB, Jeon S (2012) Responses to photodynamic therapy in patients with polypoidal choroidal vasculopathy consisting of polyps resembling grape clusters. Am J Ophthalmol 154(2):355–365. https://doi.org/10.1016/j.ajo.2012.02.019 View ArticlePubMed
Akaza E, Mori R, Yuzawa M (2008) Long-term results of photodynamic therapy of polypoidal choroidal vasculopathy. Retina 28(5):717–722. https://doi.org/10.1097/IAE.0b013e31816577cb View ArticlePubMed
Wong IY, Shi X, Gangwani R, Zhao P, Iu LP, Li Q, Ng A, Li X (2015) 1-year results of combined half-dose photodynamic therapy and ranibizumab for polypoidal choroidal vasculopathy. BMC Ophthalmol 15:66. https://doi.org/10.1186/s12886-015-0061-8 View ArticlePubMedPubMed Central
Iesato Y, Tanaka M, Murata M, Kitahara J, Hirano T, Kurenuma T, Yoshida N, Murata T (2018) Complete regression of branching vascular network in polypoidal choroidal vasculopathy by ranibizumab and photodynamic therapy, two case reports. BMC Ophthalmol 18(1):284. https://doi.org/10.1186/s12886-018-0952-6 View ArticlePubMedPubMed Central
Jia Y, Tan O, Tokayer J, Potsaid B, Wang Y, Liu JJ, Kraus MF, Subhash H, Fujimoto JG, Hornegger J, Huang D (2012) Split-spectrum amplitude-decorrelation angiography with optical coherence tomography. Opt Express 20(4):4710–4725. https://doi.org/10.1364/OE.20.004710 View ArticlePubMedPubMed Central
de Carlo TE, Bonini Filho MA, Chin AT, Adhi M, Ferrara D, Baumal CR, Witkin AJ, Reichel E, Duker JS, Waheed NK (2015) Spectral-domain optical coherence tomography angiography of choroidal neovascularization. Ophthalmology 122(6):1228–1238. https://doi.org/10.1016/j.ophtha.2015.01.029 View ArticlePubMed
Peiretti E, Iovino C, Sacconi R, Caminiti G, Querques G (2018) Optical coherence tomography angiography characteristics of polypoidal choroidal vasculopathy secondary to chronic central serous chorioretinopathy. Retina. https://doi.org/10.1097/IAE.0000000000002234 View ArticlePubMed
Wang M, Zhou Y, Gao SS, Liu W, Huang Y, Huang D, Jia Y (2016) Evaluating polypoidal choroidal vasculopathy with optical coherence tomography angiography. Invest Ophthalmol Vis Sci 57(9):OCT526–OCT532. https://doi.org/10.1167/iovs.15-18955 View ArticlePubMedPubMed Central
de Carlo TE, Kokame GT, Kaneko KN, Lian R, Lai JC, Wee R (2018) Sensitivity and specificity of detecting polypoidal choroidal vasculopathy with en face optical coherence tomography and optical coherence tomography angiography. Retina. https://doi.org/10.1097/IAE.0000000000002139 View ArticlePubMed
Srour M, Querques G, Semoun O, El Ameen A, Miere A, Sikorav A, Zambrowski O, Souied EH (2016) Optical coherence tomography angiography characteristics of polypoidal choroidal vasculopathy. Br J Ophthalmol 100(11):1489–1493. https://doi.org/10.1136/bjophthalmol-2015-307892 View ArticlePubMed
Chen Y, Yang Z, Xia F, Ning H, Hua R (2018) The blood flow characteristics of polypoidal choroidal vasculopathy and the choroidal remodelling process after photodynamic therapy. Lasers Surg Med 50(5):427–432. https://doi.org/10.1002/lsm.22801 View ArticlePubMed
Inoue M, Balaratnasingam C, Freund KB (2015) Optical coherence tomography angiography of polypoidal choroidal vasculopathy and polypoidal choroidal neovascularization. Retina 35(11):2265–2274. https://doi.org/10.1097/IAE.0000000000000777 View ArticlePubMed
Eris E, Vural E (2018) Early retinal and choroidal effect of photodynamic treatment in patients with polypoidal choroidal vasculopathy with or without anti-vascular endothelial growth factor: an optical coherence tomography angiography study. Photodiagnosis Photodyn Ther. https://doi.org/10.1016/j.pdpdt.2018.10.007 View ArticlePubMed
Azuma K, Obata R, Nomura Y, Tan X, Takahashi H, Yanagi Y (2016) Angiographic findings of ranibizumab-resistant polypoidal choroidal vasculopathy after switching to a treat-and-extend regimen with intravitreal aflibercept. Retina 36(11):2158–2165. https://doi.org/10.1097/IAE.0000000000001047 View ArticlePubMed
Ruamviboonsuk P, Tadarati M, Vanichvaranont S, Hanutsaha P, Pokawattana N (2010) Photodynamic therapy combined with ranibizumab for polypoidal choroidal vasculopathy: results of a 1-year preliminary study. Br J Ophthalmol 94(8):1045–1051. https://doi.org/10.1136/bjo.2009.173120 View ArticlePubMed
Gomi F, Oshima Y, Mori R, Kano M, Saito M, Yamashita A, Iwata E, Maruko R, Fujisan Study G (2015) Initial versus delayed photodynamic therapy in combination with ranibizumab for treatment of polypoidal choroidal vasculopathy: The Fujisan Study. Retina 35(8):1569–1576View Article
Park SJ, Choi Y, Na YM, Hong HK, Park JY, Park KH, Chung JY, Woo SJ (2016) Intraocular pharmacokinetics of intravitreal aflibercept (Eylea) in a rabbit model. Invest Ophthalmol Vis Sci 57(6):2612–2617. https://doi.org/10.1167/iovs.16-19204 View ArticlePubMed
Stewart MW, Rosenfeld PJ (2008) Predicted biological activity of intravitreal VEGF Trap. Br J Ophthalmol 92(5):667–668. https://doi.org/10.1136/bjo.2007.134874 View ArticlePubMed

Title: Early changes of vascular lesions and responses to combined photodynamic therapy in patients with polypoidal choroidal vasculopathy
Authors: Kimiko Asano-Shimizu
Shotaro Asano
Hiroshi Murata
Keiko Azuma
Yoko Nomura
Tatsuya Inoue
Asako Ogawa
Ryo Asaoka
Ryo Obata
Publication date: 01-06-2020
Publisher: Springer Netherlands
Keywords: Angiography
Photodynamic Therapy
Aflibercept
Ranibizumab
Published in: International Ophthalmology / Issue 6/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-020-01299-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Early changes of vascular lesions and responses to combined photodynamic therapy in patients with polypoidal choroidal vasculopathy

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2020

Silencing of p53 reduces cell migration in human Tenon's fibroblasts induced by TGF-β

Glaucoma care and follow-up in sub-Saharan Africa: Is there a need for modification of counselling practices to improve awareness, knowledge and treatment acceptance profiles? A prospective cross-sectional study

Outcomes of Ahmed glaucoma valve FP8 versus FP7 in adult secondary glaucoma

Diurnal variation of anterior segment parameters handled with Scheimpflug imaging in keratoconus patients

Outcome of sutured scleral fixated intraocular lens in Marfan syndrome in pediatric eyes

Clinical profile of pterygium in patients seeking eye care in India: electronic medical records-driven big data analytics report III