Comparison of different treatment intervals between bevacizumab injection and photodynamic therapy in combined therapy for age-related macular degeneration.
OBJECTIVE
To compare the results of combination therapy with different intervals between intravitreal bevacizumab and photodynamic therapy (PDT) with verteporfin for age-related macular degeneration.


METHODS
Treatment-naïve eyes (n = 184) with 12 months' follow-up were included in this retrospective case series. Eyes were classified according to the interval between bevacizumab and PDT administration: group D1, 1-day interval (n = 116); group D7, 7-day interval (n = 68). The study was conducted at two hospitals, with group D1 evaluated in one hospital and group D7 evaluated in the other. The main outcome measure was comparison of the increases in best-corrected visual acuity (BCVA) of the two groups 3 and 12 months after the initial treatment by means of analysis of covariance (ANCOVA).


RESULTS
Group D1 gained 1.3 lines and group D7 gained 1.5 lines of BCVA at 3 months; group D1 gained 0.8 lines and group D7 gained 1.4 lines at 12 months. There was a significant difference between the groups in the increased BCVA levels at 3 months (P = 0.0450) and a trend toward significance at 12 months (P = 0.0516). ANCOVA analysis revealed that baseline BCVA, hemorrhagic pigment epithelial detachment, subretinal fluid, lesion size, and a 7-day treatment interval were significantly correlated with the increase in the BCVA at 3 months.


CONCLUSIONS
A 7-day treatment interval might offer slightly better visual acuity gain in the short term than a 1-day interval.
Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. sawamiki@ophthal.med.osaka-u.ac.jp
Miki
M
Sawa
Eiji
E
Iwata
Kohei
K
Ishikawa
Fumi
F
Gomi
Kohji
K
Nishida
Hiroko
H
Terasaki
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D004396:Coloring Agents; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000008:administration & dosage; D011166:Porphyrins / Q000008:administration & dosage; D019233:Retreatment; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000077362:Verteporfin; D000068258:Bevacizumab; D007208:Indocyanine Green