J Korean Ophthalmol Soc.  2010 Jan;51(1):35-41.

Primary Combined Photodynamic Therapy and Intravitreal Bevacizumab Injection for Neovascular Age-related Macular Degeneration

• Lew YJ
• Park HJ
• Lee TG
• Lee DW
• Cho SW
• Lee JH

Abstract

PURPOSE
To investigate the efficacy of the combined treatment of photodynamic therapy (PDT) with verteporfin and intravitreal bevacizumab in patients with neovascular age-related macular degeneration.
METHODS
Forty-five eyes received a single session of PDT following three intravitreal bevacizumab (1.25 mg) injections at six-week intervals (IVB+PDT group). Twenty-seven eyes received three intravitreal bevacizuamb (1.25 mg) injections only at six-week intervals (IVB group).
RESULTS
After the six months of follow up, the mean BCVA (LogMAR) changed significantly from 0.62+/-0.34 to 0.56+/-0.33 in the IVB group (p=0.03) and from 0.61+/-0.33 to 0.48+/-0.21 in the IVB+PDT group (p=0.001). The mean BCVA was more improved in the IVB+PDT group (p=0.049). The mean CMT changes were significant in both groups immediately after treatment, but there was no significant difference at six months between the two groups. Ten eyes (37.0%) in the IVB group and 12 eyes (26.7%) in the IVB+PDT group required retreatments during the six months of follow-up (p=0.02).
CONCLUSIONS
Significant improvement in visual acuity and reduction in central macular thickness over a six-months period were observed in both groups. The mean visual acuity was significantly better and the rate of reinjections after the initial treatment schedule was lower in the IVB+PDT group.

Keyword

Age-related macular degeneration; Bevacizumab; Choroidal neovascularization; Photodynamic therapy

MeSH Terms

Antibodies, Monoclonal, Humanized
Appointments and Schedules
Choroidal Neovascularization
Eye
Follow-Up Studies
Humans
Macular Degeneration
Photochemotherapy
Porphyrins
Retreatment
Triazenes
Visual Acuity
Bevacizumab
Antibodies, Monoclonal, Humanized
Porphyrins
Triazenes

Figure

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  Figure 1. A 70-year–old woman with visual loss in her left eye was diagnosed with neovascular age-related macular degeneration. Her visual acuity was 5/200 in the left eye. Fundus photography showed subretinal fluids with subretinal hemorrhages on the macula (A). Fluorescein angiography demonstrated hyperfluorescence corresponding to leakage (B). Optical coherence tomography showed a moderate thickened retina with subretinal fluids and cystic spaces (C). The patient was offered three consecutive intravitreal injections of bevacizumab. Six months after injection, the visual acuity in the left eye was 20/70. Fundus photography showed decreased of subretinal fluids and subretinal hemorrhages (D). Fluorescein angiography showed decreased hyperfluorescein without leakage (E). Optical coherence tomography showed a significant resolution of subretinal fluids and cystic spaces (F).

• 

  Figure 2. A 71-year–old-man with visual loss in his right eye was diagnosed with neovascular age-related macular degeneration. His visual acuity was 20/70 in the right eye. Fundus photography showed subretinal fluids with subretinal hemorrhages on the macula (A). Fluorescein angiography demonstrated hyperfluorescence corresponding to leakage (B). A pigment epithelial detachment and a retinal thickening were showed by optical coherence tomography (C). The patient was offered a photodynamic therapy and three consecutive intravitreal injections of bevacizumab. Six months after injection, the visual acuity in the left eye was 20/25. Fundus photography showed complete resolution of a pigment epithelial detachment and subretinal hemorrhages (D). Fluorescein angiography showed decreased hyperfluorescein without leakage (E). Optical coherence tomography showed a complete resolution of a pigment epithelial detachment and a foveal depression (F).

Reference

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