Low fluence rate photodynamic therapy combined with intravitreal bevacizumab for neovascular age-related macular degeneration. Issue 2 (3rd December 2009)

• Record Type: Journal Article
• Authors: Costagliola, Ciro; Romano, Mario R; Rinaldi, Michele; dell'Omo, Roberto; Chiosi, Flavia; Menzione, Massimo; Semeraro, Francesco
• Is Part Of: British journal of ophthalmology. Volume 94:Issue 2(2010)
• Page Start: 180
• Page End: 184
• Publication Date: 2009-12-03
• Subjects: Age-related macular degeneration -- bevacizumab -- classic choroidal neovascularisation -- predominantly classic choroidal neovascularisation -- low fluence PDT; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjo.2009.159343
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Aims: To report the efficacy and safety of intravitreal bevacizumab (IVB) alone versus IVB plus low-fluence photodynamic therapy (PDT) in age-related macular degeneration (AMD) patients and to verify the occurrence of a synergistic effect of the combined approach on visual acuity, size and morphology of lesion, as well as on the treatment rate. Method: Prospective comparative interventional study on 85 patients with treatment-naive classic, or predominantly classic, subfoveal choroidal neovascularisation secondary to AMD. Patients were randomly assigned to group 1 (IVB injections) and group 2 (IVB plus low fluence PDT). In group 2, the PDT with verteporfin was delivered with a low fluence rate (300 mW/cm 2 for 83 s, 25 J/cm 2 ). The follow-up was scheduled at 1, 3, 6, 9 and 12 months. Results: The eye without recurrence received a mean of 2.8 (group 1) versus 1.4 (group 2) IVB injections, whereas the eyes with recurrence received a mean of 3.2 (group 1) versus 2.2 (group 2) IVB injections. The difference in reinjection rate between the two groups was statistically significant (p=0.03, ANOVA test). Visual acuity improvement was not statistically significant between the two groups (p=0.31). Conclusion: The combination of IVB with low fluence PDT for the treatment of classic or predominantly classic neovascular AMD works in a synergistic fashion with a significant reduction in IVB reinjections rate.