May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Comparison of Treatment Using Intravitreal Ranibizumab Alone With Combination Treatment Using Intravitreal Ranibizumab and Verteporfin Photodynamic Therapy in Neovascular Age-Related Macular Degeneration
Author Affiliations & Notes
  • N. M. Jabbour
    West Virginia Univ, Morgantown, West Virginia
    Ophthalmology/MARC,
    ForSight Foundation, Morgantown, West Virginia
  • J. V. Odom
    West Virginia Univ, Morgantown, West Virginia
    Ophthalmology,
  • Footnotes
    Commercial Relationships  N.M. Jabbour, Novartis, F; J.V. Odom, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 560. doi:https://doi.org/
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    • Get Citation

      N. M. Jabbour, J. V. Odom; Comparison of Treatment Using Intravitreal Ranibizumab Alone With Combination Treatment Using Intravitreal Ranibizumab and Verteporfin Photodynamic Therapy in Neovascular Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2008;49(13):560. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

To compare treatment with intravitreal ranibizumab (IVR) alone with combination treatment using IVR plus verteporfin photodynamic therapy (PDT) in neovascular age-related macular degeneration (NAMD)

 
Methods:
 

Thirty-nine eyes with NAMD were randomized to each group. The monotherapy IVR group received injections every 4 weeks for 6 consecutive injections, then PRN. The combination (IVR+PDT) group received one IVR injection 7 days after verteporfin PDT (83 seconds at 300 mW/cm2, 25J/cm2), then PRN. Eyes were evaluated with ETDRS best-corrected visual acuity (V/A), fluorescein angiography (FA), and optical coherence tomography (OCT), at baseline, weeks 1, 3 and 5, then every 4 weeks. The main outcome measures were V/A and number of treatments. Secondary outcome measures were closure of choroidal neovascularization (CNV) on FA (C) and changes in mean lesion thickness and volume on OCT.

 
Results:
 

The table summarizes outcomes for both treatment groups after a mean follow-up of 6 months. The number of treatments (P<0.0001) and C(P<0.005) were statistically significant. The C difference was more pronounced in the subgroup analysis of the IVR group. Eyes that had poor early closure (C<50%) lost vision after the 2nd and 3rd injections (mean of 5 letters), whereas eyes that had progressively better early closure (C>50%) gained vision (mean 23 letters). No systemic or ocular side-effects were noted.

 
Conclusions:
 

In this prospective case series, IVR and combination IVR+PDT therapies were safe and effective in the treatment of NAMD. Combination treatment was more efficient in reducing the number of treatments required. C analysis on FA provides an early prognostic indication to predict eyes that may not respond to IVR treatment alone.  

 
Clinical Trial:
 

www.clinicaltrials.gov NCT00570193 Pending

 
Keywords: photodynamic therapy • age-related macular degeneration 
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