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G. d'Amico, T. Caporossi, M. M. Pagliara, F. Molle, D. Lepore, F. Focosi, E. Balestrazzi; Beyond Intravitreal Injection of Anti-Vascular Endothelial Growth Factor (VEGF) Therapy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4953.
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To evaluate the efficacy and safety of double therapy consisting single-session low-fluence photodynamic therapy (PDT) with verteporfin, and intravitreal bevacizumab (IVB) for treatment of neovascular age-related macular degeneration (AMD)
20 eyes of 20 patients with subfoveal choroidal neovascularisation (CNV) secondary to AMD were treated with verteporfin PDT performed with Zeiss VISULAS 690s Photodynamic Therapy Laser System using a low-fluence protocol (25 J/cm2, 300 mW, 83 sec) immediately followed by1.25 mg of IVB (Bevacizumab). Best-corrected visual acuity (BCVA) with ETDRS test, optical coherence tomography (OCT spectral domain), fluorescein angiography (FA) and indocyanine green angiography (ICG) were performed prior to treatment. BCVA and OCT was performed at 1 month. FA was repeated at 3, 6 and 9 months. Outcome measures included best-corrected visual improvement, central subfield thickness and volume changes in OCT and angio-graphic evident of leakage.
20 eyes of 20 patients, aged 66,5 (SD 14.5) years, with a mean follow-up of one year were analysed. All patients underwent intravitreal treatment of bevacizumab once or twice (76,4 only one injection, 23,6% two injections) before to be included in our study. BCVA increased by 9,25 letters at 3 months and at 6 months showed stable vision acuity. Mean reduction in foveal thickness was 111,16 microns after only 1 month and a stable result was showed a 3 and 6 months. A mean volume reduction of 0,41 mm3 remain stable in 6 months of follow-up. No angio-graphic evidence of reactivation of CNV resulted.
In all our patients with CNV due to AMD, combined therapy results in significant and sustained visual acuity improvement after only one cycle of treatment. In addition, the therapy offers a good safety profile, potentially lower cost compared with therapies that must be administered more frequently, and convenience for patients.
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