Intravitreal bevacizumab alone versus combined verteporfin photodynamic therapy and intravitreal bevacizumab for choroidal neovascularization in age-related macular degeneration: visual acuity after 1 year of follow-up.

摘要

PURPOSE: The purpose of the study was to compare the mean change in visual acuity between bevacizumab and combined bevacizumab and photodynamic therapy for the treatment of choroidal neovascularization from age-related macular degeneration after 12 months of follow-up. METHODS: This study included a retrospective cohort of patients with untreated choroidal neovascularization. The generalized estimating equation was used to account for the correlation between eyes and to construct multivariate models to control for confounding factors of visual acuity change. RESULTS: One hundred and thirty-nine eyes treated with bevacizumab were compared with 236 eyes that received bevacizumab and photodynamic therapy (combination treatment). The monotherapy eyes showed an improvement of 0.101 +/- 0.619 logarithm of minimum angle of resolution units (5.05 letters) after a mean follow-up of 409.6 days versus 0.096 +/- 0.611 (4.8 letters) after a mean follow-up of 416.7 days with combination therapy; there was no difference between the groups (P = 0.970). The monotherapy eyes received 3.32 +/- 1.71 injections versus 3.14 +/- 1.52 injections in the combination therapy group (P = 0.665). The multivariate analysis did not show any difference between groups at the end of the study period in terms of visual improvement, worsening, stabilization, or the number of bevacizumab injections used. CONCLUSION: Long-term visual outcomes for the treatment of choroidal neovascularization in age-related macular degeneration are not improved with the addition of photodynamic therapy to bevacizumab nor are fewer injections needed.