To evaluate the long-term effects of reduced-fluence photodynamic therapy (RF-PDT) combined with intravitreal anti-vascular endothelial growth factor (anti-VEGF) for polypoidal choroidal vasculopathy (PCV).

Twenty-two eyes of 21 patients with PCV that were followed up for more than 24 months after RF-PDT and anti-VEGF combination therapy were retrospectively reviewed. The patients received intravitreal anti-VEGF (bevacizumab 1.25 mg, ranibizumab 0.5 mg, or aflibercept 2.0 mg) within 7 days of PDT. Patients were retreated with either RF-PDT and anti-VEGF injection, or with only anti-VEGF injection, as indicated. The main outcome measures were best-corrected visual acuity (BCVA) and central foveal thickness (CFT), which were measured before and after combination therapy.

During follow-up, the mean logMAR BCVA significantly improved from 0.75 at baseline to 0.54 at 12 months and 0.52 at 24 months ( p =0.009 and p =0.032, respectively). The mean CFT significantly decreased from 409.8 µm at baseline to 234.1 µm at 12 months and 245.9 µm at 24 months ( p <0.001 and p =0.001, respectively). In 20 eyes (90.9%), the BCVA remained stable or improved.

The efficacy of this combination therapy for 24 months resulted in stabilized vision and anatomical improvement. RF-PDT combined with intravitreal anti-VEGF injection could be an effective treatment modality for patients with PCV.