Comparison of photodynamic therapy to transpupillary thermotherapy for polypoidal choroidal vasculopathy

Abstract

Purpose: To compare the therapeutic efficacy of photodynamic therapy (PDT) to that of transpupillary thermotherapy (TTT) for polypoidal choroidal vasculopathy (PCV). Methods: PDT or TTT was performed on 46 eyes of 46 patients with PCV; 19 eyes were treated with TTT (TTT group) and 27 eyes with PDT (PDT group). PCV was diagnosed by fundus examination, fluorescein angiography (FA) , and indocyanine green angiography (ICGA) . The best-corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR) units and OCT-determined foveal thickness were evaluated before and after treatment. For statistical analyses, the Student's t-test and χ2 test were used. Results: The number of treatments during the 12-month follow-up period was significantly higher in the TTT group (1.7 times) than in the PDT group (1.3 times; P=0.0134). The difference in the BCVA between the TTT and PDT groups at the baseline was not significant (P=0.3150), but the BCVA in the PDT group was significantly better than that in the TTT group at 3, 6, and 12 months after treatment (P=0.0093, P=0.0074, P=0.0006, respectively). The foveal thickness decreased markedly at 6 months after treatment in the PDT group (P<0.0001) but not significantly in the TTT group (P=0.8982). A vitreous haemorrhage was observed after treatment in two eyes in the TTT group. Conclusions: BCVA was significantly better and the fovea was significantly thinner in the PDT group than in the TTT group after treatment. Thus, PDT may be more effective than TTT for the treatment of eyes with PCV. © 2009 Macmillan Publishers Limited All rights reserved.