Combination Therapy with Ocular Photodynamic Therapy for Age-Related Macular Degeneration

Purpose: To investigate the injection frequency and visual acuity (VA) outcomes with combination therapy (ranibizumab plus verteporfin photodynamic therapy, PDT) versus monotherapy (ranibizumab). Methods: A total of 40 patients with exudative age-related macular degeneration were randomized 1:1 to ranibizumab 0.3 mg plus single standard verteporfin PDT or ranibizumab 0.3 mg plus sham PDT. Ranibizumab was administered 3 times monthly followed by ‘as needed' to month 12 based on predetermined vision/anatomical criteria. Retreatment rates, VA outcomes and safety were assessed. Results: During months 3-12, combination therapy patients required fewer ranibizumab injections (mean 1.3) compared with monotherapy patients (2.8). Mean VA improved by 9.0 letters with combination therapy versus 7.5 letters in the monotherapy group at month 12. Both treatment regimens were well tolerated. Conclusion: The need for ranibizumab retreatment might be reduced by administering a single verteporfin PDT on the same day as the first ranibizumab injection, without compromising VA outcomes or safety.

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Single-Session Photodynamic Therapy Combined with Intravitreal Bevacizumab for Neovascular Age-Related Macular Degeneration

European Journal of Ophthalmology ◽

10.1177/112067210801800222 ◽

2008 ◽

Vol 18 (2) ◽

pp. 297-300 ◽

Cited By ~ 10

Author(s):

H. Ahmadieh ◽

R. Taei ◽

M. Soheilian ◽

M. Riazi-Esfahani ◽

H. Ahadi

Keyword(s):

Photodynamic Therapy ◽

Combination Therapy ◽

Macular Degeneration ◽

Case Series ◽

Intravitreal Bevacizumab ◽

Age Related Macular Degeneration ◽

Single Session ◽

Initial Combination Therapy

Purpose To evaluate the efficacy of combined single-session photodynamic therapy (PDT) and intravitreal bevacizumab (IVB) for treatment of neovascular age-related macular degeneration (AMD). Methods In a prospective interventional case series, patients with subfoveal choroidal neovascularization (CNV) underwent PDT followed by 1.25 mg IVB injection. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) measurements were repeated at 6-week intervals and fluorescein angiography was performed after 12 weeks and when considered necessary thereafter. Repeat injections of IVB were performed based on fluorescein angiographic evidence of CNV leakage. Results Fourteen eyes were included in this study. Mean follow-up was 52.4±15.2 weeks (range: 26–74 weeks). Initially, mean BCVA was 0.80±0.42 logMAR and mean central macular thickness (CMT) was 308±88 μm. At week 12, BCVA improved to 0.62±0.47 logMAR (p=0.006) and CMT reduced to 186±53 μm (p=0.003). Corresponding results were 0.53±0.52 logMAR (p=0.02) and 193±78 μm (p=0.002) after 24 weeks. A second IVB injection was performed in 13 eyes with a mean interval of 16.3±5.9 weeks. Conclusions Combination therapy with single-session PDT and IVB can improve vision and reduce CMT in neovascular AMD. Repeat IVB injections may maintain the visual gain from the initial combination therapy.

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