Two-year treatment outcome of photodynamic therapy combined with anti-vascular endothelial growth factor therapy for pachychoroid neovasculopathy

To investigate the two-year treatment outcomes of photodynamic therapy (PDT) combined with intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with pachychoroid neurovasculopathy (PNV). A retrospective study was conducted on 22 eyes of 22 treatment-naïve patients diagnosed with PNV who underwent combination therapy with PDT and intravitreal anti-VEGF agents (ranibizumab or aflibercept). Patients were followed for at least two years after treatment and evaluated for visual acuity (VA), central retinal thickness (CRT), subfoveal choroidal thickness (SCT), presence of recurrent exudative changes, time to recurrence, and additional treatments. The study involved 12 male and 10 female patients with a mean age of 64.1 ± 11.5 years. Baseline VA (0.16±0.26) improved significantly at 6 months (0.05 ± 0.23; P < 0.01), which was maintained until 24 months (0.04 ± 0.22; P < 0.01). Baseline CRT and SCT (303.1 ± 105.0 μm and 362.5 ± 83.8 μm, respectively) showed significant reductions at one month after treatment (184.5 ± 56.9 μm and 307.7 ± 94.6 μm; both P < 0.001), which were maintained until 24 months (170.8 ± 42.9 μm and 286.2 ± 99.1 μm; both P < 0.001). Recurrence was observed in five eyes (22.7%) at a mean recurrence interval of 8.5 ± 3.9 months. The mean number of additional PDT and anti- VEGF treatments was 0.2 ± 0.4 and 1.9 ± 4.5, respectively. Combination therapy with PDT and intravitreal anti-VEGF may be effective in improving visual acuity and anatomy in patients with PNV.