gms | German Medical Science

Purpose: To evaluate the effects of combination therapy of photodynamic therapy (PDT) and intravitreal therapy with anti-VEGF agents on choroidal neovascularisations (CNV) secondary to age-related macular degeneration (ARMD). Effects on ETDRS-visual acuity (VA), central retinal thickness (CRT), and fluorescein angiography were assessed.

Methods: All patients underwent a combination therapy with PDT and same-day intravitreal injection of ranibizumab at baseline (BL). Afterwards ranibizumab injections were administered at day 30, day 60, and day 90. Thereafter, patients were followed monthly and received ranibizumab injections if OCT or fluorescein angiography revealed an active lesion. Examinations included best corrected visual acuity (VA), OCT and fluorescein angiography (FA). Changes in VA and central retinal thickness measured in OCT were analysed between baseline and last follow-up.

Results: Fifteen patients (4m, 11f) aged from 54-94 years (mean 75.5±11.7 years) with occult (73%) or predominantly classic (27%) CNV were included into the study. Patients were followed for 12 months. VA showed significant increase from baseline to the 12 months visit (ETDRS Letters: 56.6±3.0 vs 68.8±4.1; p<0.01). We observed no moderate or severe loss of visual acuity during follow-up. In FA no evidence of a leaking CNV was detected at last follow-up. Central retinal thickness showed significant reduction from baseline (BL) to the 12 months visit. (CRT(BL): 322±63 µm vs. CRT(12month): 228±82 µm; p<0.01).

Conclusions: We used same-day administration of verteporfin PDT and ranibizumab as combination therapy for predominant classic CNV secondary to ARMD. This therapeutic approach leads visual gain after 12 months follow-up. Support: Novartis