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T. J. Desmettre, M. Ryckewaert, K. Glacet, I. Parmentier; Bevacizumab + Photodynamic Therapy (PDT) for the Treatment of Choroidal Neovessels of Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1794.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the interest of a therapeutic association of 2 bevacizumab intravitreous injections and one photodynamic therapy (PDT) for the treatment of choroidal neovessels (CNV) of Age Macular Degeneration (AMD).
A consecutive series of 157 patients receiving monthly bevacizumab intravitreous injections for the treatment of all types of CNV of AMD was retrospectively analyzed. After the initial diagnosis, bevacizumab was injected monthly on the basis of clinical (visual acuity, metamorphopsias) and imaging (OCT, angiography) criteria. The choice of retreatment or observation and the possibility of combining the anti-VEGF with a PDT session was left at the discretion of the ophthalmologist managing the patient.
No significant ocular nor systemic side effect was observed among the 157 patients. Among these patients a series of 31 eyes received an association of 2 bevacizumab injections + 1 PDT session (realized within the week following the second bevacizumab injection). For these 31 eyes the mean follow up is 6.2 months ; 16 eyes had complex lesions with a pigmentary epithelium detachment (PED), 6 had CNV masked by an hemorrhage, 7 had classics CNV, 2 had occult CNV. All 31 patients were naïve of any treatment before the first bevacizumab injection. All 31 patients but one (with a PED) improved both their visual acuity and retinal thickness during treatment. After the association of treatments 23 patients among the 31 remained stable until the end of follow up and did not required further treatment. Among the 126 other patients, when bevacizumab was effective, the mean number of intravitreous injections was 4.7 during the follow up period. Among the 31 patients receiving bevacizumab + PDT, those who best beneficed the treatment were the most recent classics CNV.
Our results suggest that in some cases an association of treatment involving anti-VEGF + PDT could help to allow a short term stabilization of the lesion. Further evaluation with a randomized, prospective study would be necessary to confirm these short term results.
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