[Photodynamic therapy with verteporfin combined with intravitreal injection of ranibizumab for occult and classic CNV in AMD].
OBJECTIVE
The aim of this study is to discuss the effect and outcome of a combined photodynamic therapy and intravitreal injection of ranibizumab (0.5 mg) in occult CNV with recent disease progression and in classic choroidal neovascularization (CNV) due to AMD.


METHODS
In a pilot study in 28 patients (17 classic, 11 occult CNV) an intravitreal injection of ranibizumab was administered within 12 to 24 hours after standard PDT, followed by 2 injections of ranibizumab after 1 and 2 months. Before as well as 3 and 6 months after treatment visual acuity, OCT examinations (retinal thickness) and fluorescein angiography were performed.


RESULTS
Mean visual acuity was significantly improved compared to baseline after 3 months (VA baseline 20/80, after 3 months 20/50, and 20/63 after 6 months). We found no choroidal hypoperfusion and no RPE rip. OCT and fluorescein angiography in patients with occult and classic choroidal neovascularisation after the combination therapy showed a reduced retinal thickness (baseline: 307 microm, after 1 month: 210 microm, after 3 months: 228 microm and after 6 months 281 microm) and a reduction of leakage compared to baseline.


CONCLUSIONS
Photodynamic therapy combined with injection of intravitreal ranibizumab was well tolerated and is effective. We found a stabilisation of VA in 96% of patients. Our short-term results are very promising. Further studies are necessary to show the long-term effect of the PDT and anti-VEGF combination therapy.
Maier
M M
MM
Augenklinik der Technischen Universität München, Klinikum rechts der Isar. M.Maier@lrz.tum.de
Feucht
N
N
Fiore
B
B
Winkler von Mohrenfels
C
C
Kook
P
P
Fegert
C
C
Lohmann
C
C
D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D020256:Choroidal Neovascularization / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008268:Macular Degeneration / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D010778:Photochemotherapy / Q000379:methods; D017319:Photosensitizing Agents / Q000008:administration & dosage; D010865:Pilot Projects; D011166:Porphyrins / Q000008:administration & dosage*; D000069579:Ranibizumab; D016896:Treatment Outcome; D000077362:Verteporfin; D014822:Vitreous Body / Q000187:drug effects
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D000069579:Ranibizumab