Combined intravitreal ranibizumab and verteporfin photodynamic therapy versus ranibizumab alone for the treatment of age-related macular degeneration

摘要

Purpose: To compare same-day combined therapy of photodynamic therapy with verteporfin (PDT-V)\udand intravitreal ranibizumab versus monotherapy with ranibizumab for the treatment of choroidal neovascularization.\udMethods: In this prospective study, the total number of eyes was randomized into two groups: in the first,\udtreatment consisted of a combined therapy of PDT-V and ranibizumab 0.5 mg on the same day; in the second,\udranibizumab 0.5 mg in 3 monthly injections. Best-corrected visual acuity (BCVA) and central macular\udthickness (CMT) on optical coherence tomography (OCT) were recorded before and 6 months after treatment.\udResults: A total of 47 eyes of 47 subjects were enrolled in the study. In the combined-therapy group\ud(group 1), the mean baseline BCVA ± standard deviation (SD) was 32.65 ± 11.09 letters (Snellen equivalent,\ud20/59); in the ranibizumab-alone group (group 2), 29.13 ± 9.03 letters (20/70). At 6 months’ followup,\udin group 1 the mean baseline BCVA was 39.06 ± 10.12 letters (20/42); in group 2, 33.87 ± 12.06 letters\ud(20/57). Improvement was significant in both group 1 (P = 0.03) and group 2 (P = 0.002). In group 1, the\udmean CMT at baseline ± SD was 315 ± 95.49 μm; in group 2, 306.33 ± 71.61 μm. At 6 months’ follow-up,\udin group 1 it was 202 ± 52.02 μm; in group 2, 226 ± 65.58 μm. Reduction was significant in both group 1\ud(P = 0.0007) and group 2 (P = 0.00001). After 6-months, the rate of retreated eyes was 29.4% in group 1\udand 43.3% in group 2. The need for retreatment did not depend on the treatment protocol (P = 0.34).\udConclusions: From a functional and anatomic point of view, the two treatments showed equivalent efficacy,\udwith fewer retreatments in group 1. No serious adverse events, such as retinal detachment, endophthalmitis,\udor ocular hypertension occurred in either group.