Combination therapy in exudative age-related macular degeneration: visual outcomes following combined treatment with photodynamic therapy and intravitreal bevacizumab

Can J Ophthalmol. 2010 Aug;45(4):375-80. doi: 10.3129/i10-011.

Abstract

Objective: To measure visual outcomes following combined treatment with photodynamic therapy (PDT) and intravitreal bevacizumab for exudative age-related macular degeneration (AMD).

Design: Single-centre, retrospective cohort analysis.

Participants: One hundred and seventy-four eyes in 174 patients, representing a consecutive series of all patients with at least 6 months' follow-up after combined treatment with PDT and bevacizumab for exudative AMD.

Methods: Each patient was treated with PDT, followed by intravitreal injection of bevacizumab approximately 30 minutes later. The patients were then followed at 8-12-week intervals. The primary outcome of the study was the mean change in visual acuity (VA) from baseline.

Results: One hundred seventy-four eyes in 174 patients completed at least 6 months' follow-up, with a mean duration of 10 months. The mean number of treatments was 3.0 for bevacizumab and 1.4 for PDT. After stabilization, the mean treatment-free interval was 193 days, and 52% of the patients did not require postinduction retreatment. Mean VA improved from baseline at 2, 4, and 6 months of follow-up (p < 0.05). In the subgroup analysis, treatment-naïve patients had more favorable visual outcomes (p < 0.05).

Conclusions: The combination of PDT and intravitreal bevacizumab is an effective therapy for preserving VA in patients with exudative AMD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage*
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / physiopathology
  • Combined Modality Therapy
  • Exudates and Transudates
  • Female
  • Follow-Up Studies
  • Humans
  • Injections
  • Macular Degeneration / drug therapy*
  • Macular Degeneration / physiopathology
  • Male
  • Photochemotherapy*
  • Retrospective Studies
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Visual Acuity / physiology
  • Vitreous Body

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab