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M. Funk, S. Michels, J. Wagner, C. Kiss, S. Sacu, U. Schmidt–Erfurth; Vascular Effects of Combined Ranibizumab (Lucentis®) and Verteporfin (Visudyne®) Therapy in Patients With Neovascular Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):353.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate vascular changes following combination therapy of ranibizumab and verteporfin in patients with neovascular age–related macular degeneration (AMD) by indocyanine green angiography (ICGA).
In a prospective clinical trial, eleven patients with occult (54%) or predominately classic (46%) choroidal neovascularisation (CNV) due to AMD were included. Ranibizumab was administered intravitreously at baseline, and after month 1, 2, and 3. Additionally, all patients were treated with photodynamic therapy at baseline. ICGA images were analyzed before treatment and regularly after 8, 30, 60, 90 and 180 days. Analysis included the size of the neovascular net and late hyperfluorescence consistent with leakage or staining. PDT induced hypofluorescence was evaluated in early– and late–phase ICGA.
One week after treatment, the mean size of the CNV and the mean area of late hyperfluorescence consistent with active leakage or staining was minimal, at 0.3 mm2 (11%) and 1.1 mm2 (32%) of the initial area, respectively. At day 180 there was a moderate increase of CNV size and leakage/staining to 1.75 mm2 (67%) and 2.1 mm2 (62%), respectively. Verteporfin therapy– associated choroidal hypofluorescence within the treated area showed a slowly progressive decrease in mean size from 8.01 mm2 (100%) to 1.22 mm2 (15%) in early–phase ICGA and from 5.61 mm2 (100%) to 0.50 mm2 (9%) in late–phase ICGA after 180 days.
ICGA demonstrates a reduction in CNV lesion size by combination of ranibizumab and verteporfin therapy. Choroidal perfusion recovers progressively; ICGA indicates reperfusion of the vascular net, but leakage remains absent.
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