Qian T, et al. - A meta-analysis was done to explore the options for polypoidal choroidal vasculopathy treatment. The current study showed that the combined therapy involving anti-VEGF agents and photodynamic therapy (PDT) may be more successful in improving long-term outcomes for patients with polypoidal choroidal vasculopathy (PCV) than monotherapy.

Methods

• For this study, they performed a meta-analysis of already reported studies comparing combination treatment, PDT monotherapy, and anti-VEGF monotherapy.
• In this study, primary outcome measures included changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT).
• The proportion of patients with polyp regression was regarded as the secondary outcome measure.

Results

• Total twenty studies (three RCTs and 19 retrospective studies) were included in this research.
• This study involving 1,178 patients.
• Patients with PCV were selected in this study.
• Significant differences in the proportion of patients with polyps were seen between the PDT and anti-VEGF monotherapy groups at 3 and ≥ 6 months (p <0.00001; and p=0.0001, respectively).
• Significantly greater reductions in CRT were seen in the anti-VEGF than in the PDT group at the 3-month follow-up (p=0.04).
• Significantly greater improvements in BCVA were seen in the combined therapy group than in the PDT monotherapy group at 3, 6, 12, and 24 months (p=0.03; p=0.005; p=0.02; and p <0.00001, respectively).
• Combined treatment also resulted in significantly greater improvements in BCVA than monotherapy with anti-VEGF at 6 and 24 months (p=0.001; p <0.00001, respectively), and significantly greater polyp regression than that observed following anti-VEGF treatment at 3 and ≥ 6 months (p <0.00001; p <0.0001, respectively).