Primary Combined Photodynamic Therapy and Intravitreal Bevacizumab Injection for Neovascular Age-related Macular Degeneration

ABSTRACT

PURPOSE: To investigate the efficacy of the combined treatment of photodynamic therapy (PDT) with verteporfin and intravitreal bevacizumab in patients with neovascular age-related macular degeneration. METHODS: Forty-five eyes received a single session of PDT following three intravitreal bevacizumab (1.25 mg) injections at six-week intervals (IVB+PDT group). Twenty-seven eyes received three intravitreal bevacizuamb (1.25 mg) injections only at six-week intervals (IVB group). RESULTS: After the six months of follow up, the mean BCVA (LogMAR) changed significantly from 0.62+/-0.34 to 0.56+/-0.33 in the IVB group (p=0.03) and from 0.61+/-0.33 to 0.48+/-0.21 in the IVB+PDT group (p=0.001). The mean BCVA was more improved in the IVB+PDT group (p=0.049). The mean CMT changes were significant in both groups immediately after treatment, but there was no significant difference at six months between the two groups. Ten eyes (37.0%) in the IVB group and 12 eyes (26.7%) in the IVB+PDT group required retreatments during the six months of follow-up (p=0.02). CONCLUSIONS: Significant improvement in visual acuity and reduction in central macular thickness over a six-months period were observed in both groups. The mean visual acuity was significantly better and the rate of reinjections after the initial treatment schedule was lower in the IVB+PDT group.