Subfoveal Retinal and Choroidal Thickness After Verteporfin Photodynamic Therapy for Polypoidal Choroidal Vasculopathy

PURPOSE: To evaluate the morphologic retinal and choroidal changes after verteporfin photodynamic therapy (PDT) with and without ranibizumab for polypoidal choroidal vasculopathy using spectral-domain optical coherence tomography. DESIGN: Retrospective, comparative series. METHODS: The enhanced depth imaging optical coherence tomography technique was used in this retrospective, comparative series to measure the subfoveal retinal and choroidal thicknesses before and after treatment. RESULTS: Twenty-seven eyes with polypoidal choroidal vasculopathy were examined retrospectively. Sixteen eyes were treated with PDT monotherapy (PDT group). Eleven eyes were treated with PDT after intravitreal ranibizumab injection (ranibizumab plus PDT group). The polypoidal lesions regressed in all cases at 3 months. The mean retinal thickness, including the retinal detachment, increased from 401 +/- 157 mu m before treatment to 506 +/- 182 mu m 2 days after PDT (P < .001) and decreased to 365 +/- 116 mu m by 1 week after treatment (P = .03) and 265 +/- 127 mu m by 6 months after treatment (P < .001). The mean choroidal thickness increased from 269 +/- 107 mu m before treatment to 336 +/- 96 mu m 2 days after PDT treatment (P < .001 compared with baseline) and decreased to 262 +/- 96 mu m by 1 week after treatment (P = .24) and 229 +/- 104 mu m by 6 months (P < .001). Although the choroidal thickness showed a similar trend with both therapies, the retinal thickness in the ranibizumab plus PDT group remained thinner than that in the PDT group until 6 months after treatment. CONCLUSIONS: PDT was associated with decreased retinal and choroidal thicknesses. Combination therapy reduced the transient exudation after PDT in some cases, and monthly intravitreal ranibizumab injections maintained retinal thinning and seemed to improve vision better than PDT monotherapy. (Am J Ophthalmol 2011;151:594-603. (C) 2011 by Elsevier Inc. All rights reserved.)