Choroidal morphology and short-term outcomes of combination photodynamic therapy in polypoidal choroidal vasculopathy

Purpose To investigate outcomes of combined photodynamic therapy (PDT) and intravitreal bevacizumab in association with choroidal morphology in polypoidal choroidal vasculopathy (PCV). Method Eighty-six PCV eyes (83 patients) treated with PDT in combination with intravitreal bevacizumab and followed for 1 year were evaluated. Choroidal morphological features including subfoveal choroidal thicknesses, diameter of pachyvessel, and choroidal vascularity were analyzed for association with responsiveness and recurrence. Result Total choroid, Haller's layer, and pachyvessel were thicker in responders (n = 70) compared with non-responders (n = 16) at baseline (298 vs. 227 mu m, 213 vs. 144 mu m, and 276 vs. 210 mu m, respectively; all p <= 0.001). Choroidal vascularity was significantly higher (0.68 vs 0.60, P< 0.001) and choroidal hyperpermeability was more frequent in responders (44 vs 13%, P= 0.018). Significant thinning of total choroid was observed in both responders and non-responders at 3 months after combination PDT (both P< 0.05), but the reduction was greater in responders (-33 mu m vs. - 10 mu m, P = 0.036). In recurrent eyes (n = 26), increase in pachyvessel diameter and choroidal vascularity was observed at recurrence. Conclusion Choroidal morphology including characteristic features of pachychoroid and high vascularity can serve as predictive factors for outcomes after combination PDT in eyes with PCV.