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E. Iwata, K. Ishikawa, Y. Hatta, S. Ozawa, Y. Ito, H. Terasaki; Effect of Photodynamic Therapy Combined With Intravitreal Injection of Pegaptanib or Ranibizumab on Choriocapillaris Perfusion in Eyes With Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2776.
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A transient hypoperfusion of the choriocapillaries has been reported beneath the site of photodynamic therapy (PDT). The purpose of this study was to determine the effect of verteporfin PDT combined with an intravitreal injection of pegaptanib or ranibizumab on the choriocapillaris hypoperfusion in eyes with aged-related macular degeneration (AMD).
One hundred and sixty-six eyes with a subfoveal choroidal neovascularization (CNV) due to AMD were studied. Ninety-two eyes underwent PDT alone, and 58 eyes underwent PDT with an intravitreal injection of pegaptanib, and 16 eyes underwent PDT with an intravitreal injection of ranibizumab. The PDT alone group and PDT combined therapy groups were collected at different times, and all cases were consecutive. Densitometry (Topcon IMAGEnet computer system) was used to measure the intensity of the diffuse fluorescence within the region of the PDT away from the CNV lesion and that of the normal retina just peripheral to the optic disc. The measurements were made on the indocyanine green angiograms obtained at 10 minutes 3 months after the PDT. The ratio of the average density of the fluorescence within the PDT area to that of the retina peripheral to the optic disc (irradiated/non-irradiated retinal brightness ratio=I/N brightness ratio) was calculated for each angiogram.
The I/N brightness ratios of the angiograms were 0.96 in the PDT alone group, 0.92 in the intravitreal pegaptanib-PDT group and 0.88 in the intravitreal ranibizumab-PDT group (P <0.05; Kruskal-Wallis H test). The I/N brightness ratio of the intravitreal ranibizumab-PDT group was significantly lower than that of the PDT alone group (Tukey-Kramer test P<0.05).
Intravitreal injection of ranibizumab will significantly prolong the duration of the choriocapillaris hypoperfusion after PDT.
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