title: Predictors of 1-year visual outcome in OCT analysis comparing ranibizumab monotherapy versus combination therapy with PDT in exsudative age-related macular degeneration.
abstract: OBJECTIVE
  The aim of this study was to find predictive factors of 1-year visual outcome, analyzing novel optical coherence tomography (OCT) biomarkers in exsudative age-related macular degeneration (choroidal neovascularization (CNV)) in two groups of different treatment modalities.
  
  
  METHODS
  In all, 34 consecutive patients with new-onset CNV were randomized 1:1 to receive either ranibizumab monotherapy or ranibizumab combined with photodynamic therapy (PDT) with verteporfin. After three initial injections with ranibizumab, re-treatment was performed according to an as-needed scheme; PDT was performed once at baseline. Best-corrected visual acuity (BCVA) and OCT parameters like central macular volume (CMV), central macular thickness (or central retinal thickness (CRT)), subretinal and intraretinal fluid, fibrovascular lesion thickness, or inner segment/outer segment (IS/OS) junction were analyzed.
  
  
  RESULTS
  After 12 months, a visual gain of 6.1 letters was found in the monotherapy group, whereas patients in the combination therapy group lost - 4.8 letters from baseline to the 12-month visit. CMV and CRT decreased considerably between baseline and month 2-3 in both groups, with a following slight increase until month 12. Additional application of PDT had negative effect to 12-month BCVA, whereas higher baseline BCVA and integrity of the IS/OS junction at month 12 had positive effect to 12-month BCVA.
  
  
  CONCLUSIONS
  Better baseline BCVA and the integrity of IS/OS junction at 12-month visit were the most important predictive factors for final BCVA. Combination therapy caused worse final BCVA and a higher degree of IS/OS disruption.
authors: Department of Ophthalmology, Hietzing Hospital, Wolkersbergenstrasse 1, 1130, Vienna, Austria.|Karl Landsteiner Institute of Process Optimization and QM in Cataract Surgery, Wolkersbergenstrasse 1, 1130, Vienna, Austria.
authors: Birgit
authors: B
authors: Weingessel
authors: Department of Ophthalmology, Hietzing Hospital, Wolkersbergenstrasse 1, 1130, Vienna, Austria. kata.mihaltz@wienkav.at.
authors: Kata
authors: K
authors: Mihaltz
authors: Department of Ophthalmology, Hietzing Hospital, Wolkersbergenstrasse 1, 1130, Vienna, Austria.|Karl Landsteiner Institute of Process Optimization and QM in Cataract Surgery, Wolkersbergenstrasse 1, 1130, Vienna, Austria.
authors: Pia Veronika
authors: PV
authors: Vécsei-Marlovits
mesh_terms: D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D018579:Patient Selection; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D011166:Porphyrins / Q000008:administration & dosage; D011379:Prognosis; D000069579:Ranibizumab / Q000008:administration & dosage*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000187:drug effects*; D057135:Wet Macular Degeneration / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D000069579:Ranibizumab
keywords: Age-related macular degeneration; Combination therapy; OCT; PDT; Ranibizumab; Visual outcome