Prospective comparison of low-fluence photodynamic therapy combined with intravitreal bevacizumab versus bevacizumab monotherapy for choroidal neovascularization in age-related macular degeneration

Semin Ophthalmol. 2015 Mar;30(2):112-7. doi: 10.3109/08820538.2013.833268. Epub 2013 Oct 11.

Abstract

Purpose: To evaluate combination treatment with reduced-fluence photodynamic therapy (RDPDT) with Verteporfin and intravitreal bevacizumab, compared to bevacizumab alone, for choroidal neovascularization (CNV) in age-related macular degeneration.

Methods: This was a prospective, randomized comparative study comprising 95 patients with CNV. 49 patients received RDPDT (25 J/cm(2)) followed by intravitreal bevacizumab 1.25 mg one hour later, while 46 received intravitreal bevacizumab alone. Patients were followed for 12 months at four-week intervals with visual acuity (VA) assessment and Optical Coherence Tomography (OCT) of the macula. Bevacizumab re-injections were performed as needed.

Results: On average, patients were re-injected 4.45 times in the combination group and 6.96 times in the bavacizumab group (p < 0.001). At 12 months, VA improved by 8.64 letters in the bevacizumab group and by 8.37 letters in the combination group (p = 0.922).

Conclusion: Adding a reduced-fluence PDT arm in combination with bevacizumab offers similar results to those of intravitreal bevacizumab alone with significantly reduced number of injection repetitions.

Keywords: Age-related macular degeneration; bevacizumab; choroidal neovascularization; photodynamic therapy; verteporfin.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Bevacizumab
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / physiopathology
  • Combined Modality Therapy
  • Female
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use
  • Porphyrins / therapeutic use
  • Prospective Studies
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Verteporfin
  • Visual Acuity / physiology
  • Wet Macular Degeneration / diagnosis
  • Wet Macular Degeneration / drug therapy*
  • Wet Macular Degeneration / physiopathology

Substances

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