title: Combined therapy with bevacizumab and photodynamic therapy for myopic choroidal neovascularization: A one-year follow-up controlled study.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of a combined treatment for myopic choroidal neovascularization (CNV) using photodynamic therapy (PDT) and intravitreal bevacizumab and to compare it with intravitreal bevacizumab monotherapy.
  
  
  METHODS
  Thirty-four eyes with angiographic evidence of myopic CNV were randomly divided into two groups: 17 were treated with one intravitreal bevacizumab injection (1.25 mg) and low-fluence-rate PDT within seven days of the injection (Group A). The other 17 received monotherapy with bevacizumab injections (Group B). Clinical evidence of complications, best corrected visual acuity (BCVA) and fluorescein leakage were evaluated. BCVA and optical coherence tomography (OCT) were evaluated monthly. The timepoints follow-up was established at 6 and 12mo. All patients were retreated following a PRN protocol.
  
  
  RESULTS
  A total of 34 eyes of 34 patients (26 women and 8 men) with a mean age of 62.35 years were included. In Group A (17 eyes) the mean BCVA increased from 0.55±0.13 logMAR before the treatment to 0.40±0.09 logMAR at the 12mo follow-up (P<0.01). In Group B (17 eyes) the mean BCVA increased from 0.60±0.11 logMAR before the treatment to 0.55±0.12 logMAR at the 12mo follow-up (P<0.01). There was no statistically significant difference between the two groups in terms of LogMar visual acuity. In Group A the mean number of combined treatments was 1.8±0.11 per patient; in Group B the mean number of intravitreal bevacizumab injections was 3.1±0.08 per patient. The number of treatments was significantly fewer in Group A (P<0.01). No local or systemic side effects occurred among any of the patients treated in this study.
  
  
  CONCLUSIONS
  The combination of anti-angiogenic injections and PDT appears to be a safe and effective option for myopic CNV treatment and allows for a significant reduction of intravitreal injections.
authors.affiliation: University Eye Clinic, University of Trieste, Ospedale Maggiore, Trieste 34129, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Saviano
authors.affiliation: University Eye Clinic, University of Trieste, Ospedale Maggiore, Trieste 34129, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Piermarocchi
authors.affiliation: University Eye Clinic, University of Trieste, Ospedale Maggiore, Trieste 34129, Italy.
authors.forename: Pia E
authors.initials: PE
authors.lastname: Leon
authors.affiliation: University Eye Clinic, University of Trieste, Ospedale Maggiore, Trieste 34129, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mangogna
authors.affiliation: University Eye Clinic, University of Trieste, Ospedale Maggiore, Trieste 34129, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Zanei
authors.affiliation: Eye Clinic of Padova, University of Padova, Padova 35128, Italy.
authors.forename: Fabiano
authors.initials: F
authors.lastname: Cavarzeran Sc
authors.affiliation: University Eye Clinic, University of Trieste, Ospedale Maggiore, Trieste 34129, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Tognetto
keywords: bevacizumab; combined therapy; myopia; neovascularization; photodynamic therapy