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M. A. Samuel, QUEST Investigator Study Group; Verteporfin PDT in Double or Triple Combination Therapy: The Visudyne® QUEST Registry. Invest. Ophthalmol. Vis. Sci. 2008;49(13):261.
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To assess real-world treatment regimens and outcomes of verteporfin photodynamic therapy (vPDT) in double (with ranibizumab) or triple (with ranibizumab or bevacizumab plus a steroid) treatment for patients with choroidal neovascularization (CNV) due to age-related macular degeneration (AMD).
Retrospective database study of patients who received either (1) ranibizumab within ±14 days of vPDT, or (2) vPDT combined with intravitreal ranibizumab or bevacizumab and an intravitreal steroid (such as dexamethasone or triamcinolone), where all three components were delivered within 14 days of each other. Patient consent and ethics board approval were obtained before investigators entered data into a secure Web-accessed database. Inclusion criteria: subfoveal CNV due to AMD treated at least once with either double or triple therapy as described. Study eye visual acuity (VA) was captured as Snellen scores and converted to logMAR for statistical calculations. Required follow-up data included VA assessment, dilated eye exam, intraocular pressure check, serious adverse event reporting, and additional treatment(s), if any.
Of the 342 patients with at least 3 months of follow-up, 29% received double therapy and 71% received triple therapy. At baseline, mean VA was 0.908 logMAR (20/162). Mean follow-up was 7.4 months (range 3.0-16.7 months). Patients received a mean of 0.2 vPDT retreatments and 1.4 anti-VEGF retreatments. By 4 months of follow-up, patients overall (n=303) gained a mean of 6.7 letters of VA, and those treated with double therapy (n=91) or triple therapy (n=212) gained a mean of 7.8 and 6.3 letters, respectively. In addition, 81% of double-therapy patients and 82% of triple-therapy patients lost less than 5 letters of VA or gained VA by this time point. Ten patients experienced serious adverse events (1 ocular; 9 non-ocular). No event was considered by the investigators to be related to any of the three treatments.
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