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Combined intravitreal anti-VEGF and verteporfin photodynamic therapy for juxtafoveal and extrafoveal choroidal neovascularization as an alternative to laser photocoagulation. Eye (Lond) 2010 Apr;24(4):713-6

Date

06/06/2009

Pubmed ID

19498454

DOI

10.1038/eye.2009.122

Scopus ID

2-s2.0-77951107292 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

PURPOSE: To evaluate anti-VEGF and photodynamic therapy (PDT) for juxtafoveal and extrafoveal choroidal neovascularization (CNV) due to age-related macular degeneration (ARMD), ocular histoplasmosis syndrome (OHS), and degenerative myopia.

METHODS: A total of 10 eyes with juxtafoveal or extrafoveal choroidal neovascularization underwent intravitreal anti-VEGF therapy combined with verteporfin PDT (689 nm). Most treatments consisted of PDT every 12 weeks and either ranibizumab 0.5 mg every 4 weeks or bevacizumab 1.25 mg every 6 weeks, initiated concurrently. Retreatment criteria were persistent exudative signs on optical coherence tomography or fluorescein angiography.

RESULTS: Presenting visual acuity (VA) ranged from 20/20 to 20/60 (mean log MAR+/-SD, 0.338+/-0.16 (20/44 equivalent)). After a mean follow-up of 17.5 months, it ranged from 20/15 to 20/40 (mean log MAR+/-SD, 0.150+/-0.14 (20/28 equivalent); P=0.027, paired t-test). Six eyes improved by > or = 2 lines and four remained within 2 lines of initial VA. Non-ARMD eyes required much fewer treatments than ARMD eyes. All five non-ARMD eyes and three of five ARMD eyes showed no CNV activity at least 5 months after last treatment.

CONCLUSIONS: Anti-VEGF therapy and PDT can preserve good visual function and may be suited to some cases of nonfoveal CNV. ARMD eyes require longer courses of treatment than non-ARMD eyes.

Author List

Han DP, McAllister JT, Weinberg DV, Kim JE, Wirostko WJ

Authors

Dennis P. Han MD Adjunct Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
Judy E. Kim MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
David V. Weinberg MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
William Wirostko MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Angiogenesis Inhibitors
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Bevacizumab
Choroidal Neovascularization
Drug Therapy, Combination
Humans
Photochemotherapy
Photosensitizing Agents
Porphyrins
Ranibizumab
Vascular Endothelial Growth Factor A
Visual Acuity