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Low fluence rate photodynamic therapy combined with intravitreal bevacizumab for neovascular age-related macular degeneration.

Author(s): Costagliola C, Romano MR, Rinaldi M, dell'Omo R, Chiosi F, Menzione M, Semeraro F

Affiliation(s): Dipartimento di Scienze per la Salute, Universita degli Studi del Molise, Campobasso, Italy.

Publication date & source: 2010-02, Br J Ophthalmol., 94(2):180-4. Epub 2009 Dec 3.

Publication type: Randomized Controlled Trial

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/cm2 for 83 s, 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 (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.

Page last updated: 2010-10-05

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