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Combination treatments of photodynamic therapy and intravitreal anti-vascular endothelial growth factor drugs for exudative age-related macular degeneration

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Author:
No author available
Journal Title:
Chinese Journal of Ocular Fundus Diseases
Issue:
6
DOI:
10.3760/cma.j.issn.1005-1015.2011.06.005
Key Word:
黄斑变性/治疗;脉络膜新生血管化/治疗;抗体,单克隆/治疗应用;光化学疗法;Macular degeneration/therapy;Choroidal neovascularization/therapy;Antibodies,monoclonal/therapeutic use;Photochemotherapy

Abstract: Objective To observe the efficacy of intravitreal injection of ranibizumab (Lucentis) and combination treatments of photodynamic therapy (PDT) and intravitreal injection of ranibizumab for exudative age-related macular degeneration (eAMD).Methods Thirty eyes from 30 patients with eAMD were enrolled in this study.Fifteen eyes were treated with intravitreal injection of ranibizumab (ranibizumab group),while 15 eyes were treated with combination treatments of PDT and intravitreal injection of ranibizumab (combination group).The follow-up ranged from 6 to 17 months with a mean of 12.5 months.The patients in ranibizumab group received intravitreal injection of ranibizumab (0.5 mg) once a month for 12 consecutive months.Follow-up visits were performed monthly after the first injection.The patients in the combination group received intravitreal injection of ranibizumab (0.5 mg) within 24 hours after PDT.Then the same dose of intravitreal injection was given the 2nd and 3rd months.They were examined on follow-up visits monthly after the 3rd injection.Injections were repeated if necessary during follow-up period.The mean number of repetitive intravitreal injections of ranibizumab was (3.7 ± 1.0) times/eye.Changes in best corrected visual acuity (BCVA),results of optic coherence tomography (OCT),fundus fluorescein angiography (FFA) and MP-1,injection times and complications were observed.Results The 1st,3rd,6th and 12th month after treatment,the average improvement value in mean light sensitivity (MS)were 1.9,3.8,5.0 and 5.5 dB in ranibizumab group; 2.0,4.2,3.7 and 4.8 dB in combination group respectively.The difference between two groups was not statistically significant (P>0.05).The differences of improvement in BCVA and OCT between two groups also were not statistically significant (P>0.05).The MS has positive relationship with BCVA (r =0.660,P < 0.05 ).No complications such as endophthalmitis,retinal pigment epithelial tear or vitreous hemorrhage were observed during the follow-up period.Conclusions Both intravitreal injection of ranibizumab and combination treatments of PDT and intravitreal injection of ranibizumab are effective for eAMD.Combination of PDT and ranibizumab therapy decreases the frequency of retreatment.

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