RFPDT with anti-VEGF for Polypoidal Choroidal Vasculopathy
The aim was to study the efficacy of combined therapy with reduced-fluence photodynamic therapy (RFPDT) and intravitreal bevacizumab/ranibizumab from the Indian subcontinent.Thirty-five eyes of 34 patients diagnosed with polypoidal choroidal vasculopathy were included. All the patients underwent RFPDT, followed by intravitreal bevacizumab/ranibizumab.

Regression of polyps after a single session of RFPDT was seen in five eyes; multiple sessions of treatment were required in thirty eyes. An average number of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections given were 4 ± 1.9 and average number of PDT sessions were 1.2 ± 0.5. Visual acuity improvement was seen in 21 (60%) eyes (P < 0.001), decrease in visual acuity was seen in 7 (20%) eyes (P = 0.016), and in 7 eyes (20%), vision remained stable. Regression of polypoidal lesions was seen in 80% of cases. No complications of massive subretinal hemorrhage or breakthrough vitreous hemorrhage were noted in our patients. The mean follow-up period was 18 months (range, 12–24 months).

RFPDT with anti-VEGF is safe and effective treatment with polyp regression and vision improvement in 80% of cases, without any complication of subretinal hemorrhage/vitreous hemorrhage.