title: Combination photodynamic therapy and intravitreal ranibizumab in neovascular age-related macular degeneration in a North Indian population: a pilot study.
abstract: OBJECTIVE
  To evaluate photodynamic therapy (PDT) with verteporfin along with intravitreal ranibizumab in treatment of neovascular age-related macular degeneration.
  
  
  METHODS
  This prospective interventional care series included 16 patients (17 eyes) of choroidal neovascularization secondary to neovascular age-related macular degeneration who were treated with PDT with verteporfin followed by an injection of 0.5 mg ranibizumab on the same day. The main outcome measures were best corrected visual acuity as recorded by both Snellen and Early Treatment Diabetic Retinopathy Study (ETDRS) charts (logMAR), contrast sensitivity (Pelli-Robson Chart), retreatment frequency, and frequency of side effects.
  
  
  RESULTS
  Seventeen eyes underwent PDT with verteporfin and intravitreal 0.5 mg ranibizumab, following PDT. Patients were followed up every month for a total period of 6 months. Initial visual acuity ranged from CF to 20/32 and final acuity ranged from CF to 20/20. Visual acuity stabilized (gain/loss <2 lines) in 14 out of 17 eyes (82.35%) and improved in 3 out of 17(17.65%). Contrast sensitivity improved in 15 out of17 eyes (82.24%) There were no cases of ocular/systemic adverse events. Retreatment was required in only 2 out of 17 cases (11.76%) with a single injection of intravitreal ranibizumab.
  
  
  CONCLUSIONS
  The combination of PDT with intravitreal ranibizumab improves contrast sensitivity and stabilizes vision and reduces the number of retreatments, without significant ocular/systemic risks.
authors.affiliation: Dr. R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. akum66mm@yahoo.co.in
authors.forename: Atul
authors.initials: A
authors.lastname: Kumar
authors.forename: Kiran
authors.initials: K
authors.lastname: Gopalakrishnan
authors.forename: Subijoy
authors.initials: S
authors.lastname: Sinha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D015350:Contrast Sensitivity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D007267:Injections; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D010865:Pilot Projects; D011166:Porphyrins / Q000627:therapeutic use; D011446:Prospective Studies; D000069579:Ranibizumab; D019233:Retreatment / Q000706:statistics & numerical data; D000077362:Verteporfin; D014792:Visual Acuity; D014822:Vitreous Body
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D000069579:Ranibizumab