Intravitreal Ranibizumab and Low Fluence Photodynamic Therapy to Treat Choroidal Neovascularization Due to Age-Related Macular Degeneration

Abstract

Purpose: : To evaluate efficacy and safety of intravitreal ranibizumab (IVR) and low fluence photodynamic therapy (LFPDT) protocol to treat choroideal neovascularization due to age-related macular degeneration (AMD-CNV)

Methods: : twenty-three eyes with AMD-CNV (12 naïve and 11 already treated with standard PDT) underwent combined treatment with 0.03 mg IVR (1/month for 3 months) and LFPDT (parameters reduced to 25mJ/cm2, 300mW/cm2, with standard dose of verteporfin and timing) after 5-14 days. Best corrected visual acuity (BCVA) was measured using ETDRS charts; biomicroscopy, fluorescein angiography (FA), and optical coherence tomography (OCT) were performed, in order to evaluate functional and anatomical outcomes

Results: : Mean follow-up was 8.6±2.2 months (range: 5-15). BCVA was improved in all patients and also in subgroups analysis (p>0.05). No patient experienced severe visual loss. No patient showed FA leakage. OCT demonstrated neuroretinal detachement resolution in 20/23 (87%) ad RPE detachment resolution in 9/15 (60%). Three eyes (13%) had IVR+LFPDT single retreatment. No complication were observed.

Conclusions: : combined IVR+LFPDT therapy is safe and effective in AMD-CNV, improving visual acuity and anatomical conditions. Further controlled study is warranted to demonstrate the long term efficacy and safety of this treatment option.

Keywords: age-related macular degeneration • choroid: neovascularization • injection