Treatment of polypoidal choroidal vasculopathy by photodynamic therapy, aflibercept and dexamethasone triple therapy

Polypoidal choroidal vasculopathy is a relatively common type of degenerative macular disease among the Chinese population. This study aims to describe the therapeutic responses to combination therapy with photodynamic therapy, intravitreal aflibercept and intravitreal dexamethasone in patients with polypoidal choroidal vasculopathy. A prospective series of 17 eyes of 13 patients suffering from treatment-naïve polypoidal choroidal vasculoapathy were recruited. All cases received triple therapy with photodynamic therapy, intravitreal aflibercept and intravitreal dexamethasone and one year outcomes were reported. The baseline visual acuity was 0.65logMAR +/− 0.38 (Snellen 20/80 to 20/100). The visual acuity at 1 week, 3 months, 6 months and one year after treatment were significantly improved to 0.522logMAR+/− 0.365 (P < 0.04) (Snellen 20/70), 0.363logMAR+/−0.382 (Snellen 20/50;P < 0.001), 0.377logMAR +/− 0.440 (Snellen 20/50;p = 0.005), and 0.35logMAR +/− 0.407 (Snellen 20/40;P < 0.001), respectively. The baseline central foveal thickness (CFT) on optical coherence tomography (OCT) was 394.7 +/− 70.6 μm. CFT at 6 months and 1 year after treatment were significantly reduced to 259 +/− 54 μm (p = 0.004) and 271 +/− 49.7 μm(p = 0.016), respectively. Triple therapy with photodynamic therapy, intravitreal aflibercept and intravitreal dexamethasone is an effective treatment for polypoidal choroidal vasculopathy. The majority of cases responded well with significant responses observed as early as 1 week after initiation of therapy.