MARUKO Ruka    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Endowed Assistant Professor
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	INITIAL VERSUS DELAYED PHOTODYNAMIC THERAPY IN COMBINATION WITH RANIBIZUMAB FOR TREATMENT OF POLYPOIDAL CHOROIDAL VASCULOPATHY: The Fujisan Study.
Journal	Formal name：Retina (Philadelphia, Pa.) Abbreviation：Retina ISSN code：15392864/0275004X
Domestic / Foregin	Foregin
Volume, Issue, Page	35(8),pp.1569-76
Author and coauthor	Gomi Fumi, Oshima Yuji, Mori Ryusaburo, Kano Mariko, Saito Masaaki, Yamashita Ayana, Iwata Eiji, Maruko Ruka,
Publication date	2015/08
Summary	PURPOSE:To compare the 1-year results of initial or deferred photodynamic therapy (PDT) combined with intravitreal ranibizumab (IVR) for eyes with polypoidal choroidal vasculopathy.METHODS:Prospectively, 72 men with treatment-naive polypoidal choroidal vasculopathy were randomized to initial or later PDT combined with IVR. In both groups, 2 additional monthly IVR followed. From Month 3, PDT and IVR were administered according to the retreatment criteria. Mean changes in the best-corrected visual acuity between baseline and Month 12 and central retinal thickness, the rate of eyes showing regression of polypoidal lesions, and number of additional treatments were compared.RESULTS:The best-corrected visual acuity increased by a mean of 8.1 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters in the initial PDT group and 8.8 ETDRS letters in the later PDT group, and there was a no significant difference (P = 0.59). The mean central retinal thickness decreased significantly in both groups but more so with combination therapy within the first 4 months; the difference was not significant at Month 12 (P = 0.30). The rate of eyes showing resolution of polypoidal lesions at 12 months was 62.1% in the initial PDT group and 54.8% in the later PDT group and again, there was no significant difference (P = 0.53). The mean number of additional IVR was 1.5 in initial PDT and 3.8 in later PDT; that of additional PDTs was 0.14 and 0.45, respectively, and they were significantly different (P < 0.001 and P = 0.013, respectively).CONCLUSION:Both initial and deferred PDT combined with IVR to treat polypoidal choroidal vasculopathy show the similar visual and anatomical improvements at 12 months. Initial PDT combination leads to significantly fewer additional treatments.
DOI	10.1097/IAE.0000000000000526
PMID	25830698