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M. J. Wan, P. Hooper, T. Sheidow; Combination Therapy in Exudative Age-Related Macular Degeneration: Visual Outcomes Following Combined Treatment With Photodynamic Therapy and Bevacizumab Injection. Invest. Ophthalmol. Vis. Sci. 2008;49(13):544.
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The purpose of this study was to examine the visual outcomes after combined treatment with photodynamic therapy (PDT) and intravitreal bevacizumab for exudative age-related macular degeneration.
This study represents a single-centre, retrospective cohort analysis. All patients treated with a combination of PDT and intravitreal injection of bevacizumab (1.25 mg) were included in the analysis. Standard treatment protocol was to perform both procedures on the same day (approximately 30 minutes apart) followed by a second injection of bevacizumab 6 weeks later. The main outcome measures were change from baseline in Snellen visual acuity, rate and timing of retreatment, and complication rate.
176 eyes in 176 patients completing at least 6 months followup are reported with a mean duration of followup of 9.7 months. The mean number of treatments was 3.0 for bevacizumab and 1.4 for PDT. After receiving the standard treatment protocol, 48% of the patients did not require any form of retreatment. The mean Snellen visual acuity improved by 8.1 letters after 4 months of followup and remained above baseline at 6, 8 and 12 months and at the last visit. The proportion of patients whose visual acuity improved or remained stable was 78% at 6 months and 66% at 12 months. In the subgroup analysis, patients who were treatment naïve (no previous PDT), less than 80 years old, and hypertensive had more favorable visual outcomes. There were no serious ocular or systemic complications.
The combination of PDT and intravitreal bevacizumab appears to be safe and effective in the treatment of exudative age-related macular degeneration.
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