Enlargement of Choroidal Neovascularizatıon before Recurrence after Photodynamic Therapy for Pachychoroid Neovasculopathy

Purpose: To investigate predictors of recurrent exudation in choroidal neovascularization (CNV) of pachychoroid neovasculopathy (PNV) after photodynamic therapy (PDT).

Methods: Consecutive, treatment-naïve, symptomatic patients with PNV with subfoveal retinal fluid (SRF) treated with PDT and followed for 18 months were studied retrospectively. CNV areas were calculated from optical coherence tomography angiography (OCTA) images obtained at various time points after the initial PDT.

Results: In 52 eyes, the SRF resolved completely 3 months after PDT, in 23 (44%) eyes the exudation recurred during the 18-month follow-up period. In 29 eyes with no recurrence, the mean baseline square root of the CNV area of 1.91 mm [95% confidence interval (CI), 0.27] decreased significantly (P = 0.006) to 1.47 mm (95% CI, 0.16) at 3 months after PDT and decreased further until 12 months after PDT (mean, 1.26 mm; 95% CI, P < 0.001) and was maintained thereafter. In 23 eyes with a recurrence, the square root of the CNV area enlarged significantly (P = 0.028) from 1.43 mm (95% CI, 0.21) at the examination 3 months before the recurrence to 1.73 mm (95% CI, 0.18) at the recurrence.

Conclusion: CNV enlargement during the follow-up period after PDT for PNV may predict recurrence.

Hikichi T, Kubo N, Tabata M, Kurabe H. Enlargement of choroidal neovascularization before recurrence after photodynamic therapy for pachychoroid neovasculopathy. Retina. 2023 https://pubmed.ncbi.nlm.nih.gov/37224464/

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