Bevacizumab Monotherapy Versus Combined Therapy with Photodynamic Therapy for Occult Choroidal Neovascularization in Age-Related Macular Degeneration

ABSTRACT

PURPOSE: To compare clinical outcomes between intravitreal bevacizumab (IVB) monotherapy and combined therapy with half-fluence rate verteporfin photodynamic therapy (PDT) for occult choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). METHODS: Medical records were reviewed in consecutive patients who underwent IVB monotherapy or combined therapy with PDT for occult CNV secondary to AMD and had a 12-month follow-up period. After 3 consecutive monthly IVB injections, both groups were eligible for additional IVB injections when necessary. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and number of additional IVB injections were compared between the groups. RESULTS: Thirty-nine eyes underwent IVB monotherapy (IVB group) and 25 eyes underwent combined therapy (PDT+IVB group). Mean BCVA improved significantly in the PDT+IVB group (p = 0.046) and not in IVB group (p = 0.213). A significant reduction in mean CMT occurred in both groups (p < 0.001). The mean number of additional IVB injections was 1.6 +/- 1.33 in the IVB group and 0.5 +/- 1.01 in the PDT+IVB group (p = 0.001). There were no serious complications. CONCLUSIONS: Combined therapy with half-fluence rate PDT improved BCVA and reduced the number of additional IVB injections in the eyes with occult CNV secondary to AMD.