Journal article
Combination therapy for neovascular age-related macular degeneration refractory to anti-vascular endothelial growth factor agents
Ophthalmology (Rochester, Minn.), Vol.120(10), pp.2029-2034
10/2013
DOI: 10.1016/j.ophtha.2013.03.016
PMID: 23714319
Abstract
To examine the outcomes of combination anti-vascular endothelial growth factor (VEGF) and photodynamic therapy (PDT) for the treatment of neovascular age-related macular degeneration (AMD) refractory to anti-VEGF monotherapy. Retrospective, interventional case series. Twenty-six eyes of 26 patients treated with anti-VEGF monotherapy for neovascular AMD with persistent subretinal or intraretinal fluid after at least 3 anti-VEGF injections in the 7 months before combination treatment. Combination anti-VEGF treatment and PDT. Visual acuity at 1 or 2, 3, and 6 months and central retinal thickness at 1 or 2, 3, and 6 months. Secondary outcome measures were change in number of fluid-free visits and interval between treatments in the 7 months before and 6 months after combination therapy. Statistically significant improvements in logarithm of the minimum angle of resolution visual acuities were present at 1 month (P = 0.01) and 3 months (P = 0.01). Significant decreases in central subfield retinal thickness on optic coherence tomography (OCT) were seen at 1 month (P = 4×10(-5)), 3 months (P = 3×10(-4)), and 6 months (P = 4×10(-5)) as compared with precombination treatment OCT scans. The percentage of patient visits with no subretinal fluid increased from 0.5% to 41% after the initiation of combination therapy (P = 1×10(-5)). The interval between treatments increased from once every 1.6 months in the 7 months before combination treatment to once every 2.7 months in the 6 months after combination treatment (P = 0.002). No ocular complications attributable to PDT were seen. Rescue therapy with the combination of anti-VEGF and PDT in eyes that have failed anti-VEGF monotherapy resulted in a mean improvement in vision, a decreased central subfield retinal thickness, and an increase in fluid-free intervals. The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Details
- Title: Subtitle
- Combination therapy for neovascular age-related macular degeneration refractory to anti-vascular endothelial growth factor agents
- Creators
- Kevin Tozer - Doheny Eye Institute and the Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; VMR Institute, Huntington Beach, CaliforniaA Brock RollerLawrence P ChongSriniVas SaddaJames C FolkVinit B MahajanStephen R RussellH Culver BoldtElliott H Sohn
- Resource Type
- Journal article
- Publication Details
- Ophthalmology (Rochester, Minn.), Vol.120(10), pp.2029-2034
- DOI
- 10.1016/j.ophtha.2013.03.016
- PMID
- 23714319
- NLM abbreviation
- Ophthalmology
- ISSN
- 0161-6420
- eISSN
- 1549-4713
- Publisher
- United States
- Grant note
- EY03040 / NEI NIH HHS K08EY020530 / NEI NIH HHS K08 EY015237 / NEI NIH HHS
- Language
- English
- Date published
- 10/2013
- Academic Unit
- Stead Family Department of Pediatrics; Ophthalmology and Visual Sciences
- Record Identifier
- 9983979969502771
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