A randomised trial of bevacizumab and reduced light dose photodynamic therapy in age-related macular degeneration: the VIA study.
OBJECTIVE
To determine if reduced light-dose photodynamic therapy (PDT) combined with bevacizumab will decrease the number of bevacizumab treatments required over 6 months compared with bevacizumab monotherapy in neovascular age-related macular degeneration (AMD).


METHODS
Thirty-six patients with neovascular AMD were recruited for this randomised, double-masked, controlled clinical trial. Patients received intravitreal bevacizumab plus PDT using a light dose of either 25 J/cm2 (group 1) or 12 J/cm2 (group 2), or intravitreal bevacizumab plus sham PDT (group 3). Patients returned monthly for possible retreatment with bevacizumab or combination therapy (with a 3-month minimum interval between combination treatments); retreatment decisions were primarily based on optical coherence tomography. The main outcome measure was the mean number of bevacizumab treatments required over 6 months.


RESULTS
Patients required a mean of 2.8 bevacizumab treatments in group 1 and 2.5 in group 2, compared with 5.1 in group 3 (p = 0.005 and p<0.001, respectively).


CONCLUSIONS
Combination bevacizumab and 25 J/cm2 or 12 J/cm2 PDT significantly reduced the number of bevacizumab treatments required over 6 months. This study was powered to examine number of treatments, but not visual acuities. Nevertheless, visual acuities responded favourably in all three groups. Further studies will be helpful to explore visual outcomes.
Potter
M J
MJ
Department of Ophthalmology and Visual Sciences, University of British Columbia, 2550 Willow Street, Vancouver, British Columbia, Canada, V5Z 3N9. michael.potter88@gmail.com
Claudio
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Szabo
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D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods*; D012160:Retina / Q000473:pathology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000187:drug effects
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab