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F. Chiosi, F. Semeraro, P. Danzi, M. Rinaldi, M. Romano, C. Costagliola; Effect of Combined Intravitreal Bevacizumab and Photodynamic Therapy at Reduced Light Fluence Rate in the Treatment of Choroidal Neovascularization Secondary to Pathologic Myopia. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2272.
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To report the safety and efficacy of combined intravitreal bevacizumab (IVB) and photodynamic therapy (PDT) with verteporfin performed at reduced (RF) light fluence rate in the treatment of choroidal neovascularization (CNV) secondary to pathologic myopia.
16 consecutive patients with myopic CNV non responder to IVB alone were included in this retrospective interventional study. Mean spherical equivalent was -13.41 ± 3.76 diopters (range: from -8 to -20). All patients received 1.25 mg IVB followed by RF-PDT (25 J/cm²) 2 days later. Best-corrected visual acuity (BCVA-ETDRS), foveal thickness (FT) and fluorescein and indocyanine green angiographies (FA; ICG) were recorded. Follow-up evaluations were carried out for 12 months.
An improvement of mean BCVA (baseline 26.47 ± 11.82 letters; 12 month check 38.53 ± 15.78 letters, p = 0.039), together with a reduction of mean FT (baseline 236.6 ± 59.5 µm; 12 month check 190 ± 38.14 µm, p = not significant) occurred. At the 12th month 15 patients (95%) showed no fluorescein leakage from the CNV, whereas only one patient (5%) even revealed persistent leakage. No signs of chorioretinal atrophy were observed. None of the 15 eyes with CNV closure experienced recurrence over the follow-up period.
IVB injection combined with RF-PDT is able to manage CNV secondary to pathologic myopia, as assessed throughout 12 month follow-up. A significant improvement of BCVA together with a reduction of FT has been documented. Combination therapy reduces the recurrence rate during 12 months follow-up.
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