Abstract
Purpose: :
To evaluate the efficacy and safety of triple therapy with verteporfin photodynamic therapy (PDT), dexamethasone, and bevacizumab in CNV secondary to AMD.
Methods: :
This prospective, noncomparative, interventional case series included 104 patients. PDT was administered with a reduced light dose (42 J/cm2, accomplished by light delivery time of 70 seconds). About 16 hours after PDT, dexamethasone (800 µg) and bevacizumab (1.5 mg) were applied intravitreally. Patients attended follow-up visits every 6 weeks, undergoing VA and intraocular pressure measurement, slit-lamp and ophthalmoscopic examination, and optical coherence tomography. Fluorescein angiography was performed every 3 months or earlier if OCT showed significant edema.
Results: :
All 104 patients received one triple therapy cycle (5 patients received a second triple treatment due to remaining CNV activity). The triple therapy was complemented in 23 patients (22.1%) by an additional intravitreal injection of bevacizumab. The mean follow-up period is currently at 62 weeks. Mean increase in visual acuity was 1.78 lines (P<0.01). Mean decrease in retinal thickness was 171 µm (P<0.01). No serious adverse events have been observed.
Conclusions: :
In most of the patients with CNV due to AMD, triple 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 and convenience for patients.
Keywords: choroid: neovascularization • age-related macular degeneration • corticosteroids