Photodynamic Therapy Combined With Intravitreal Ranibizumab Injection Treating Polypoidal Choroidal Vasculopathy

Objective: To determine the effect of photodynamic therapy(PDT) combinedintravitreal ranibizumab(IVR) for polypoidal choroidal vasculopathy (PCV).Methods: From November2011to November2012, at the Ophthalmology OutpatientDepartment of our hospital as well as the Xiangya Second Hospital, there were26patients(27eyes) diagnosed with Polypoidal Choroidal Vasculopathy (PCV). Amongthem, people aged between38and78years old were selected. The sample includes16male(17eyes) and10female(10eyes). They were separated at random into threetreatment groups. The A group was treated with PDT. If disease progression orrecurrence the leakage went on during follow-up，the patients were re-treatment withPDT.The B group was treated with an intravitreal injection of ranibizumab,receivedintravitreal injection of ranibizumab (0.5mg,0.05ml)once a month for3consecutive months. If disease progression or recurrence the leakage went on duringfollow-up，the patients were re-injected with ranibizumab．The C group was treatedwith PDT combined IVR. The combined group was treated with an intravitrealinjection of ranibizumab (0.5mg)72hour within PDT. If disease progression orrecurrence the leakage went on during follow-up，the patients were re-injectedwith IVR or re-treatment PDT. All the patients completed12months of follow-up.The best-corrected visual acuity (BCVA)，examination of the ocular fundus，fluorescence fluorescein angiography (FFA)， indocyanine green angiography(ICGA) and optical coherence tomography (OCT) were retrospectively performed1，3，6and12months after treatment．Results:1. All the patients completed12months of follow-up. The mean BCVAimproved, throughout12months in all groups（P＜0.05），comparison between the threegroups with the differences were not significan（tP＞0.05）；The BCVA at one months after, all of which were significantly Improve compared with the differences werenot significant（P＞0.05），comparison between the three groups with the differenceswere not significant（P＞0.05）； At3and6months after, the B groups of BCVA isbetter than that of group A and group C, comparison between the three groups withthe differences were not significant（P＞0.05）；At12months after, the C groups ofBCVA is better than that of group A and group B, comparison between the threegroups with the differences were not significant（P＞0.05）；2. All the patients completed12months of follow-up. The mean CRT throughout12months in all groups which significantly decreased compared with before treatment（P＜0.05），comparison between the three groups with the differences were significant（P＜0.05）；The CRT at one months after, all of which were significantly decreasedcompared with the differences were not significant（P＞0.05），comparison betweenthe three groups with the differences were not significant（P＞0.05）；At3monthsafter, Group A compared with group B with the differences were significant（P＜0.05）；Group A compared with group C with the differences were not significant（P＞0.05）；Group B compared with group C with the differences were significant（P＜0.05）；3. At the final follow-up，Group A:FFA and ICGA showed no leakagein7eyes，leakage reduced in2eyes，and slight leakage in3eyes; Group B: FFA andICGA showed leakage reduced in5eyes，and slight leakage in2eyes; Group C: Noleakage of all.4. the treatment rate of PDT was1．18in group A; Group B, the intravitrealinjections of ranibizumab was3.43; group C,；the treatment rate of PDT was1，wh1ile that of that of IVR is1．22.Conclusions:1. Photodynamic therapy, intravitreal injection of ranibizumabcombined with photodynamic therapy intravitreal ranibizumab injections are effectiveand safe for the patients with PCV． Photodynamic Therapy Combined WithIntravitreal Ranibizumab may stop or reduce leakage of the lesion，facilitate theabsorption of hemorrhage， edema and exudates， and stabilize or increase the patients’ visual acuity．2. PDT with IVR can reduce the number of injections Ranibizumab.