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O. F. Brasil, H. S. Maia, A. S. Maia, O. M. Brasil; Short-Term Efficacy of Combined Photodynamic Therapy and Intravitreal Bevacizumab for Subfoveal Choroidal Neovascular Membranes Secondary to Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1815.
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To evaluate the short-term outcomes of combined treatment with photodynamic therapy (PDT) and intravitreal bevacizumab for subfoveal choroidal neovascular membranes secondary to age-related macular degeneration (AMD).
Retrospective case series of patients who met the following criteria: choroidal neovascular membrane secondary to AMD treated with PDT with verteporfirin, receipt of 1.25mg/0.05ml intravitreal bevacizumab 7 days after PDT, at least 2 months of follow-up, fluorescein angiography and optical coherence tomography (OCT) performed at baseline and monthly afterwards. Re-treatment with intravitreal bevacizumab was indicated on a monthly basis when subsensory fluid was present in OCT scans. Main outcome measures were 1 and 2-months visual acuities and re-treatment rates.
Ten eyes of 10 patients were included. Mean age was 76.9 ± 9.01 years and 70% were females. Lesion composition was predominantly classic in 30% of the cases, minimally classic in 30% of the cases and occult with no classic in 40% of the cases. Mean visual acuity was 0.27 ± 0.18 at baseline (Snellen equivalent 20/109), 0.34 ± 0.3 after 1 month (Snellen equivalent 20/58) and 0.34 ± 0.33 after 2 months (Snellen equivalent 20/58). Two months after the initial treatment vision had improved ≥1 Snellen line in 50% of the patients and remained stable or decreased ≤1 Snellen line in 30% of the patients. There was no statistically significant relation between visual acuities at the different time intervals. Re-treatment with intravitreal bevacizumab was performed in 30% of the cases after 1 month and 40% of the cases after 2 months.
Combined treatment of choroidal neovascular membranes secondary to AMD with PDT and intravitreal bevacizumab may lead to short-term visual improvement. Re-treatment may be required in approximately one third of the cases monthly in the first 2 months.
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