Abstract
Purpose: :
To discuss the effect and outcome of a combined photodynamic therapy and intravitreal injection of ranibizumab (0.5 mg) in occult CNV with recent disease progression and in classic choroidal neovascularisation (CNV) due to AMD.
Methods: :
In a pilot study in 25 patients (18 classic, 7 occult CNV) intravitreal injection of ranibizumab was administered within 12 to 24 hours after standard PDT, followed by 2 injections of ranibizumab after 1 and 2 months. Before, 3 and 6 month after treatment visual acuity, OCT examinations (retinal thickness) and fluorescein angiography were performed.
Results: :
Mean visual acuity was significantly improved compared to baseline. (VA baseline 20/80, after 3 month 20/50, and 20/63 after 6 month). We found no choroidal hypoperfusion and no RPE rip. OCT-findings and fluorescein angiography in patients with occult and classic choroidal neovascularisation 3 and 6 month after combination therapy showed a reduced retinal thickness (baseline: 241µm, after 3 month: 205µm and after 6 month 232µm) and reduction of leakage compared to baseline.
Conclusions: :
Photodynamic therapy combined with injection of intravitreal ranibizumab was well tolerated and tends to be more effective compared to ranibizumab mono-therapy. Our short term results are very promising. Further studies are necessary to show the long term effect of PDT and Anti-VEGF combination therapy.
Keywords: age-related macular degeneration • vascular endothelial growth factor • vitreous