One-year follow-up of combined customized therapy. Photodynamic therapy and bevacizumab for exudative age-related macular degeneration.
OBJECTIVE
To evaluate whether combined, personalised photodynamic therapy (PDT) and Bevacizumab in choroidal neovascularization associated with age-related macular degeneration can improve vision, and whether it is possible to decrease the frequency and number of intravitreal antiangiogenics.


METHODS
A prospective, noncomparative, interventional study of a case series of 63 patients with exudative age-related macular degeneration, treated with an initial dose of PDT and intravitreal Bevacizumab 24 to 48 hours afterwards. Retreatments were carried out as required with monthly Bevacizumab and PDT every 3 months if there were relapses. Follow-up lasted 1 year in all cases.


RESULTS
After the first month of treatment, the mean best-corrected visual acuity increased by 4.85 letters, reaching 5.65 letters at the 12-month follow-up (P < 0.05). Compared with initial vision, 79.3% of the eyes had the same or better vision and 95.2% lost fewer than 15 letters. The total number of PDT treatments was 92 (a mean of 1.46 treatments per patient). The mean number of Bevacizumab injections was two per patient. In 29 cases (46%), only one initial treatment with PDT + Bevacizumab was necessary. In 15 cases (23.8%), more than two combined treatments per patient were necessary.


CONCLUSIONS
Combined, customized PDT + Bevacizumab therapy makes it possible to obtain visual results similar to those obtained in monotherapy, but with fewer intravitreal injections. It appears to be an interesting option for this type of patients.
Fundación Oftalmológica del Mediterráneo, Bifurcación Pío Baroja-General Avilés s/n, Valencia, Spain. navea_amp@gva.es
Amparo
A
Navea
Jorge
J
Mataix
M Carmen
MC
Desco
Maria
M
Garcia-Pous
Elena
E
Palacios
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D003131:Combined Modality Therapy; D005122:Exudates and Transudates; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D019233:Retreatment; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D017319:Photosensitizing Agents; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab