Factors influencing visual outcome of polypoidal choroidal vasculopathy one year after photodynamic therapy.

Background: Polypoidal choroidal vasculopathy (PCV) is considered to be a good indication for photodynamic therapy (PDT). We evaluated pre-PDT factors predicting better visual acuity (VA) 1 year after PDT in patients with PCV.

Methods: We evaluated 181 eyes of 181 patients who underwent PDT and were followed up for 1 year. Additional treatments, if needed, were given every 3 months, with a maximum of four PDT sessions, for up to 9 months. We compared best-corrected VA (BCVA) 1 year after PDT with that before PDT. Pre-PDT factors favoring better BCVA 1 year after PDT were evaluated using stepwise multiple regression analysis.

Results: Mean BCVA improved from 0.29 +/- 0.15 before PDT to 0.43 +/- 0.32 1 year after PDT (p < 0.001). BCVA improved in 55 eyes (30.4%), and was maintained in 110 (60.8%). Pre-PDT factors predicting better BCVA at 1 year were better initial BCVA (beta = 0.271, p < 0.001) within our eligibility criteria up to 0.6, a relatively small diameter of a network of vessels plus polypoidal lesions on indocyanine green angiography (beta = 0.249, p < 0.001), and the absence of a polypoidal lesion under the fovea (beta = 0.175, p = 0.011).

Conclusion: Better BCVA can be expected 1 year after PDT in eyes with PCV showing better initial BCVA, relatively small lesions on indocyanine green angiography, and no subfoveal polypoidal lesion before PDT.