Skip to main content

Advertisement

SpringerLink
Log in

Photodynamic therapy for polypoidal choroidal vasculopathy: Vaso-occlusive effect on the branching vascular network and origin of recurrence

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To determine whether photodynamic therapy (PDT) has a vaso-occlusive effect on the branching vascular network in polypoidal choroidal vasculopathy (PCV) and whether PDT can prevent future recurrence.

Methods

We analyzed pre-and post-PDT indocyanine green angiography (ICGA) results of 27 patients (27 eyes) who were diagnosed with PCV and who had shown clinical improvement accompanied by occlusion of polypoidal lesions after PDT. We also investigated the recurrent events in these patients and the origin of the recurrences.

Results

The branching vascular network persisted, at least in part, in 20 (87%) of 23 eyes undergoing one PDT session and in two (50%) of four eyes undergoing two PDT sessions. In the remaining five eyes, we could not determine definitively whether the branching vessels were occluded completely. Recurrent serous changes occurred in nine eyes (33%) 14–48 months after the last PDT. ICGA revealed that these changes were caused by new polypoidal lesions that originated from further-grown branches of the persistent branching vascular network. Diffuse leakage from undetermined sources seemed to coexist in two eyes.

Conclusions

PDT cannot induce complete occlusion of the branching vascular network. PDT does not prevent future recurrence, because new active polypoidal lesions may develop from the persistent branching vessels in the network.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Yannuzzi LA, Sorenson J, Spaide RF, Lipson B. Idiopathic polypoidal choroidal vasculopathy. Retina 1990;10:1–8.

    Article  CAS  PubMed  Google Scholar 

  2. Spaide RF, Yannuzzi LA, Slakter JS, et al. Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy. Retina 1995;15:100–110.

    Article  CAS  PubMed  Google Scholar 

  3. Yannuzzi LA, Ciardella A, Spaide RF, et al. The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy. Arch Ophthalmol 1997;115:478–485.

    Article  CAS  PubMed  Google Scholar 

  4. Uyama M, Matsubara T, Fukushima I, et al. Idiopathic polypoidal choroidal vasculopathy in Japanese patients. Arch Ophthalmol 1999;117:1035–1042.

    Article  CAS  PubMed  Google Scholar 

  5. Uyama M, Wada M, Nagai Y, et al. Polypoidal choroidal vasculopathy: natural history. Am J Ophthalmol 2002;133:639–648.

    Article  PubMed  Google Scholar 

  6. Yuzawa M, Mori R, Haruyama M. A study of laser photocoagulation for polypoidal choroidal vasculopathy. Jpn J Ophthalmol 2003;47:379–384.

    Article  PubMed  Google Scholar 

  7. Quaranta M, Mauget-Faysse M, Coscas G. Exudative idiopathic polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin. Am J Ophthalmol 2002;134:277–280.

    Article  PubMed  Google Scholar 

  8. Spaide RF, Donsoff I, Lam DL, et al. Treatment of polypoidal choroidal vasculopathy with photodynamic therapy. Retina 2002;22:529–535.

    Article  PubMed  Google Scholar 

  9. Chan WM, Lam DS, Lai TY, et al. Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy: one-year results of a prospective case series. Ophthalmology 2004;111:1576–1584.

    Article  PubMed  Google Scholar 

  10. Lee SC, Seong YS, Kim SS, et al. Photodynamic therapy with verteporfin for polypoidal choroidal vasculopathy of the macula. Ophthalmologica 2004;218:193–201.

    Article  CAS  PubMed  Google Scholar 

  11. Silva RM, Figueira J, Cachulo ML, et al. Polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin. Graefes Arch Clin Exp Ophthalmol 2005;243:973–979.

    Article  CAS  PubMed  Google Scholar 

  12. Bressler NM. 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: one-year results of 2 randomized clinical trials-TAP report 1. Arch Ophthalmol 1999;117:1329–1345.

    Article  CAS  Google Scholar 

  13. Yuzawa M, Mori R, Kawamura A. The origins of polypoidal choroidal vasculopathy. Br J Ophthalmol 2005;89:602–607.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. MacCumber MW, Dastgheib K, Bressler NM, et al. Clinicopathologic correlation of the multiple recurrent serosanguineous retinal pigment epithelial detachments syndrome. Retina 1994;14:143–152.

    Article  CAS  PubMed  Google Scholar 

  15. Yannuzzi LA, Wong DW, Sforzolini BS, et al. Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration. Arch Ophthalmol 1999;117:1503–1510.

    Article  CAS  PubMed  Google Scholar 

  16. Ahuja RM, Stanga PE, Vingerling JR, et al. Polypoidal choroidal vasculopathy in exudative and haemorrhagic pigment epithelial detachments. Br J Ophthalmol 2000;84:479–484.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Lafaut BA, Aisenbrey S, Van den Broecke C, et al. Polypoidal choroidal vasculopathy pattern in age-related macular degeneration: a clinicopathologic correlation. Retina 2000;20:650–654.

    CAS  PubMed  Google Scholar 

  18. Okubo A, Sameshima M, Uemura A, Kanda S, Ohba N. Clinicopathological correlation of polypoidal choroidal vasculopathy revealed by ultrastructural study. Br J Ophthalmol 2002;86:1093–1098.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Kuroiwa S, Tateiwa H, Hisatomi T, et al. Pathological features of surgically excised polypoidal choroidal vasculopathy membranes. Clin Experiment Ophthalmol 2004;32:297–302.

    Article  PubMed  Google Scholar 

  20. Schmidt-Erfurth U, Michels S, Kusserow C, et al. Photodynamic therapy for symptomatic choroidal hemangioma. Ophthalmology 2002;109:2284–2294.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Kangnam St. Mary’s Hospital, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Korea

    Won Ki Lee, Phil Young Lee & Sang Kyu Lee

Authors
  1. Won Ki Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Phil Young Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sang Kyu Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Won Ki Lee.

About this article

Cite this article

Lee, W.K., Lee, P.Y. & Lee, S.K. Photodynamic therapy for polypoidal choroidal vasculopathy: Vaso-occlusive effect on the branching vascular network and origin of recurrence. Jpn J Ophthalmol 52, 108–115 (2008). https://doi.org/10.1007/s10384-007-0501-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-007-0501-y

Key Words

Search

Navigation