Indocyanine Green Angiography: Guided Photodynamic Therapy for Polypoidal Choroidal Vasculopathy

Purpose To report the 12-month follow-up results of subfoveal polypoidal choroidal vasculopathy (PCV) patients treated with indocyanine green angiography (ICGA)-guided photodynamic therapy (PDT). Design Interventional, noncomparative cases series. Methods A retrospective analysis of the clinical and angiographic data related to 47 PCV eyes that were followed up for 12 months was carried out. The greatest linear dimension (GLD) for PDT was determined based on the ICGA findings. Optical coherence tomography (OCT) also was used to evaluate the therapeutic effects. Results The mean logarithm of the minimum angle of resolution visual acuity (VA; 0.58 ± 0.37) significantly improved to 0.53 ± 0.38 at three months ( P = .04) and to 0.46 ± 0.40 at 12 months ( P = .02). The average ICGA GLD (2682.3 ± 1026.9 mm) was significantly ( P = .0001) smaller than the presumed fluorescein angiography (FA) GLD (4043.6 ± 1914.8 mm). In more than 80% of cases, complete resolution of retinal exudative changes was observed. Although polypoidal vascular lesions disappeared in 82.2% of eyes, the branched vascular networks showed little change. The initial VA and GLD had little correlation with the VA outcome. Conclusions ICGA-guided PDT reduces the size of laser exposure and is an effective treatment for PCV. Because PCV may appear as occult choroidal neovascularization (CNV) on FA, PCV should be diagnosed using ICGA before treatment because PCV may respond differently than CNV to appropriate treatment.