Combination therapy in exudative age-related macular degeneration: visual outcomes following combined treatment with photodynamic therapy and intravitreal bevacizumab.
OBJECTIVE
To measure visual outcomes following combined treatment with photodynamic therapy (PDT) and intravitreal bevacizumab for exudative age-related macular degeneration (AMD).


METHODS
Single-centre, retrospective cohort analysis.


METHODS
One hundred and seventy-four eyes in 174 patients, representing a consecutive series of all patients with at least 6 months' follow-up after combined treatment with PDT and bevacizumab for exudative AMD.


METHODS
Each patient was treated with PDT, followed by intravitreal injection of bevacizumab approximately 30 minutes later. The patients were then followed at 8-12-week intervals. The primary outcome of the study was the mean change in visual acuity (VA) from baseline.


RESULTS
One hundred seventy-four eyes in 174 patients completed at least 6 months' follow-up, with a mean duration of 10 months. The mean number of treatments was 3.0 for bevacizumab and 1.4 for PDT. After stabilization, the mean treatment-free interval was 193 days, and 52% of the patients did not require postinduction retreatment. Mean VA improved from baseline at 2, 4, and 6 months of follow-up (p < 0.05). In the subgroup analysis, treatment-naïve patients had more favorable visual outcomes (p < 0.05).


CONCLUSIONS
The combination of PDT and intravitreal bevacizumab is an effective therapy for preserving VA in patients with exudative AMD.
Wan
Michael J
MJ
Ivey Eye Institute and Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont.
Hooper
Phil L
PL
Sheidow
Tom G
TG
D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000503:physiopathology; D003131:Combined Modality Therapy; D005122:Exudates and Transudates; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D010778:Photochemotherapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab