Combined argon laser photocoagulation and antivascular endothelial growth factor for management of macular polypoidal choroidal vasculopathy.

AIM: To evaluate the efficacy of combination therapy of argon laser photocoagulation and intravitreal antivascular endothelial growth factor (VEGF) injection in idiopathic polypoidal choroidal vasculopathy (PCV) involving macula.

MATERIALS AND METHODS: A retrospective interventional study involving 12 eyes of 11 patients diagnosed with PCV involving the macula on indocyanine green angiography (ICGA). Intravitreal anti-VEGF was given in eyes with significant subretinal/sub retinal pigment epithelium hemorrhage or exudation. ICGA-guided focal laser was done to extrafoveal leaking polyps. Mean change in best-corrected visual acuity (BCVA) and regression of polyp as seen on ICGA were evaluated at the final follow-up.

STATISTICAL ANALYSIS: It was done using SPSS 17.0. - Mann-Whitney test.

RESULTS: 12 eyes of 11 patients underwent argon laser with intravitreal anti-VEGF injection. Ten patients were males and one female. Mean age was 65.75 ± 5.2 years. The mean number of injections given was 3.66 ± 1.5 (2-6) per eye. Mean number of laser sessions required was 1.33 ± 0.65 (1-3) per eye. BCVA improved in 25% ( n = 3), remained stable in stable in 50% ( n = 6) eyes, and decreased in 25% ( n = 3) eyes. The regression of polypoidal lesions on ICGA was seen in 75% ( n = 9) of eyes. Persistent subretinal fluid seen in 25% ( n = 3) of eyes. The mean duration of follow-up was 15.41 ± 10.27 (3-36) months.

CONCLUSION: Combined argon laser photocoagulation with intravitreal anti-VEGF injection helps in decreasing exudation and results in stabilization of the disease with visual improvement in eyes with PCV involving macula.