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M. M. Maier, K. Haas, N. Feucht, B. Fiore, A. Clos, C. P. Lohmann; Photodynamic Therapy With Verteporfin Combined With Intravitreal Injection of Bevacizumab for Occult and Classic CNV in AMD. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1826.
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To discuss the effect and outcome of a combined photodynamic therapy and intravitreal injection of Bevacizumab in occult and classic choroidal neovascularisation (CNV) due to AMD. Esp. occult CNV with pigment epithelium detachment (PED) are not likely to respond positively to standard photodynamic therapy, often ending up in PED enlargement or rip of the RPE.
In a pilot study in 20 Patients intravitreal injection of Bevacizumab was administered within 12 to 24 hours after standard PDT to reduce post PDT increase of proangiogenic and inflammatory factors.
In all patients the visual acuity was stabilized or improved (mean VA at baseline was 20/125, after 1 month 20/80, after 3 month 20/80, and 20/100 after 6 month) and an enlargement of the PED in occult CNV was prevented. We found no RPE rip. Presented are angiographic- and OCT-findings in patients with occult and classic choroidal neovascularisation 1, 3 and 6 month after combination therapy.
Photodynamic therapy is still indicated in predominantly classic and occult subfoveal CNV with recent disease progression. PDT monotherapy is limited in the treatment of occult CNV with PED. PDT combined with injection of intravitreal Bevacizumab tend to be more effective by reducing the post-PDT increase of vascular growth and inflammatory factors.
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