Reduced-fluence verteporfin photodynamic therapy plus ranibizumab for choroidal neovascularization in pathologic myopia.
BACKGROUND
To demonstrate the efficacy of intravitreal ranibizumab (IVR) in combination with reduced-fluence photodynamic therapy (RF-PDT) in patients with choroidal neovascularization (CNV) secondary to pathologic myopia.


METHODS
Sixty patients affected by myopic CNV (mCNV) were randomized to receive either ranibizumab 0.5 mg monotherapy (RM; n = 20), standard fluence PDT (SF-PDT, n = 20) or RF-PDT combination therapy (n = 20). Subsequently, IVR was injected as needed. All patients were evaluated for 48 weeks.


RESULTS
Mean BCVA change at 48 weeks was + 0.2 and +15 letters with SF or RFPDT plus ranibizumab, respectively, compared with +16.8 letters with RM. At 48 weeks, mean central foveal thickness (CFT) decrease from baseline was 58 ± 15 μm, 91.4 ± 43.8 μm, and 85 ± 41.5 μm for the verteporfin SF, RF and RM groups, respectively. Macular sensitivity improvement was + 0.4 db, + 1.9 dB and + 2.7 dB for the verteporfin SF, RF and RM groups, respectively.


CONCLUSIONS
Ranibizumab monotherapy or combined with RF-PDT improved BCVA and macular sensitivity in patients affected by mCNV, whereas CFT results were reduced. SF-PDT combination regimen mostly stabilized vision at 48 weeks. Among all groups, the RF-PDT seemed to reduce the number of ranibizumab retreatments.
Eye Clinic, Department of Ophthalmology, Seconda Università degli Studi di Napoli, Naples, Italy.
M
M
Rinaldi
Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Brescia, Italy.
F
F
Semeraro
Eye Clinic, Department of Medicine and Health Sciences, University of Molise, Via Francesco De Sanctis 1, 86100, Campobasso, Italy. flaviachiosi@yahoo.it.
F
F
Chiosi
Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Brescia, Italy.
A
A
Russo
Eye Clinic, Department of Neuroscience, University Federico II, Naples, Italy.
M R
MR
Romano
Department of Ophthalmology, Catholic University "Sacro Cuore, A. Gemelli", Rome, Italy.
M C
MC
Savastano
Eye Clinic, Department of Medicine and Health Sciences, University of Molise, Via Francesco De Sanctis 1, 86100, Campobasso, Italy.
R
R
dell'Omo
Eye Clinic, Department of Medicine and Health Sciences, University of Molise, Via Francesco De Sanctis 1, 86100, Campobasso, Italy.|IRCCS Neuromed, Pozzilli, Isernia, Italy.
C
C
Costagliola
D000328:Adult; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D002829:Choroid / Q000473:pathology; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D047728:Myopia, Degenerative / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use*; D011446:Prospective Studies; D000069579:Ranibizumab / Q000008:administration & dosage*; D012029:Refraction, Ocular; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity; D014794:Visual Fields
D020533:Angiogenesis Inhibitors; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D000069579:Ranibizumab
Choroidal neovascularization; Microperimetry; Pathologic myopia; Ranibizumab; Reduced-fluence verteporfin photodynamic therapy
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