Combination photodynamic therapy and intravitreal ranibizumab in neovascular AMD in a north Indian population: a pilot study.
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 AMD, who were treated with PDT with verteporfin followed by an injection of 0.5mg Ranibuzimab on the same day. The main outcome measures were best corrected visual acuity (VA) as recorded by both Snellen's and ETDRS charts (logMAR), contrast sensitivity (Pelli-Robson Chart), retreatment frequency and frequency of side effects.


RESULTS
Seventeen eyes underwent PDT with verteporfin and intravitreal 0.5mg Ranibizumab, following PDT. Patients were followed up every month for a total period of 6 months. Initial VA ranged from CF to 20/32 and final acuity ranged from CF to 20/20. VA stabilizes (gain/loss <2 lines) in 14 out of 17 eyes (82.24%) and improved in 3 out of 17 (17.65%). Contrast sensitivity improved in 15 out of 17 eyes (82.24%) Lesion type, patient age had no influence on the outcome. There were no cases of ocular/systematic adverse events. Retreatment was required in only 2 out of 17 cases (11.76%) with only a single injection of ranibizumab.


CONCLUSIONS
The combination of PDT with intravitreal Ranibizumab improves contrast sensitivity and stabilizes vision and reduces the number of retreatments, without significant ocular and/or systematic risks.
Kumar
Atul
A
India Institute of Medical Sciences, New Delhi, India. akum66mm@yahoo.co.in
Gopalakrishnan
Kiran
K
Sinha
Subijoy
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D044466:Asian People; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology; D015350:Contrast Sensitivity / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007194:India; D007267:Injections; D008268:Macular Degeneration / Q000150:complications* / Q000208:ethnology; 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; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D000069579:Ranibizumab