June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Long-term Results of Combination Therapy with Half-time Reduced Fluence Photodynamic Therapy and Intravitreal Ranibizumab for Retinal Angiomatous Proliferation
Author Affiliations & Notes
  • Hirotaka Yokouchi
    Ophthalmology, Chiba Univ Graduate School of Med, Chiba, Japan
  • Masayasu Kitahashi
    Ophthalmology, Chiba Univ Graduate School of Med, Chiba, Japan
  • Madoka Sakurai
    Ophthalmology, Chiba Univ Graduate School of Med, Chiba, Japan
  • Mariko Kubota-Taniai
    Ophthalmology, Chiba Univ Graduate School of Med, Chiba, Japan
  • Takayuki Baba
    Ophthalmology, Chiba Univ Graduate School of Med, Chiba, Japan
  • Shuichi Yamamoto
    Ophthalmology, Chiba Univ Graduate School of Med, Chiba, Japan
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3792. doi:
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    • Get Citation

      Hirotaka Yokouchi, Masayasu Kitahashi, Madoka Sakurai, Mariko Kubota-Taniai, Takayuki Baba, Shuichi Yamamoto; Long-term Results of Combination Therapy with Half-time Reduced Fluence Photodynamic Therapy and Intravitreal Ranibizumab for Retinal Angiomatous Proliferation. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3792.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To determine the efficacy of half-time reduced fluence photodynamic therapy (RF-PDT) combined with intravitreal ranibizumab (IVR) for retinal angiomatous proliferation (RAP).

 
Methods
 

Ten eyes of 10 patients with RAP were studied; there were 2 eyes with RAP stage II A, 3 eyes with stage II B, and 5 eyes with stage III. One course of combination therapy consisted of three injections of IVR at monthly intervals and a single half-time RF-PDT with verteporfin about 1-3 days after the first IVR. The dose and fluence of the half-time RF-PDT were administered according to the standard protocol for age-related macular degeneration (AMD). The laser was applied for 42 seconds guided by the indocyanine green angiographic images. The best-corrected visual acuity (BCVA) in logMAR units and central foveal thickness (CFT) measured on the optical coherence tomographic (OCT) images were examined before and 12 months after treatment.

 
Results
 

The BCVA significantly improved from 0.76±0.11 to 0.60±0.10 logMAR units 12 months after the treatment (P=0.01). The BCVA improved by ≥0.15 logMAR units in 6 eyes (60%), remained stable in 3 eyes (30%), and worsened in 1 eye (10%). The CFT was significantly reduced from 613.0±91.8 μm to 217.6±39.1 μm (P=0.001) at 12 months. The CFT decreased by ≥30% in 8 eyes (80%), remained stable in 2 eyes (20%), and worsened in no eye. No additional treatment was required in 6 eyes (60%), but additional IVR was required in 4 eyes. A complete occlusion of the retina-retinal anastomosis (RRA) was achieved and central macular edema (CME) disappeared in 9 eyes at 12 months. The mean number of PDT treatments and mean number of IVR injections during 12 months, including that of the initial regimen, was 1 and 3.6, respectively. No complications such as severe vision loss, endophthalmitis, occlusion of the choriocapillaris, or systemic events developed.

 
Conclusions
 

Combined IVR and half-time RF-PDT for RAP effectively maintained or improved visual acuity and reduced the exudation for at least 12 months. Although further evaluations with a larger number of patients and a longer follow-up are required, our results suggest a beneficial effect of the combination therapy for RAP.

 
Keywords: 412 age-related macular degeneration • 647 photodynamic therapy  
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