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Low fluence rate photodynamic therapy combined with intravitreal bevacizumab for neovascular age related macular degeneration.
  1. Ciro Costagliola1,
  2. Mario R Romano1,*,
  3. Michele Rinaldi2,
  4. Robeto dell'Omo1,
  5. Flavia Chiosi2,
  6. Massimo Menzione2,
  7. Francesco Semeraro3
  1. 1 University of Molise, Italy;
  2. 2 Second University of Naples, Italy;
  3. 3 University of Brescia, Italy
  1. Correspondence to: Mario R Romano, University of Molise, Via F. De Sanctis, Campobasso, 86100, Italy; romanomario{at}email.it

Abstract

Aims: to report efficacy and safety of intravitreal bevacizumab (IVB) alone versus IVB plus low fluence 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 (CNV) 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 low fluence rate (300mW/cm2 for 83seconds, 25 J/cm2). The follow-up was scheduled at 1-,3-,6-, 9- and 12-months.

Results: The eye without recurrence received a mean of 2.8 (Group1) vs 1.4 (Group2) IVB injections, whereas the eyes with recurrence received a mean of 3.2 (Group1) vs 2.2 (Group2) IVB injections. The difference in re-injections 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 of IVB re-injections rate.

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