Combined Treatment of Photodynamic Therapy and Bevacizumab for Choroidal Neovascularization Secondary to Age-Related Macular Degeneration
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: To evaluate the outcome of a combined photodynamic therapy and intravitreal injection of bevacizumab in choroidal neovascularization secondary to age-related macular degeneration. Methods: Photodynamic therapy (PDT) was administered to 28 eyes followed by 3 consecutive bevacizumab injections. Patients were followed-up for more than 12 months. At baseline, 1, 3, 6, and 12 months post PDT, visual acuity (VA) and central macular thickness were measured using optical coherence tomography. Results: The mean VA was significantly improved from logarithm of the minimal angle of resolution 0.86 at baseline to 0.69 at 1 month (p = 0.011), 0.63 at 3 months (p = 0.003), 0.64 at 6 months (p = 0.004) and 0.60 at 12 months (p < 0.001). Central macular thickness decreased significantly from 328.3 μm at baseline to 230.0 μm at 6 months and 229.9 μm at 1 year (p < 0.001). Reinjection mean number was 0.4 for 6 months and 0.8 for 12 months. By 1year, retreatment was performed in 10 eyes (36%). Conclusions: PDT combined with three consecutive intraviteal bevacizumab injections was effective in improving VA and reducing central macular thickness.
Abstract
Purpose: To evaluate the outcome of a combined photodynamic therapy and intravitreal injection of bevacizumab in choroidal neovascularization secondary to age-related macular degeneration. Methods: Photodynamic therapy (PDT) was administered to 28 eyes followed by 3 consecutive bevacizumab injections. Patients were followed-up for more than 12 months. At baseline, 1, 3, 6, and 12 months post PDT, visual acuity (VA) and central macular thickness were measured using optical coherence tomography. Results: The mean VA was significantly improved from logarithm of the minimal angle of resolution 0.86 at baseline to 0.69 at 1 month (p = 0.011), 0.63 at 3 months (p = 0.003), 0.64 at 6 months (p = 0.004) and 0.60 at 12 months (p < 0.001). Central macular thickness decreased significantly from 328.3 μm at baseline to 230.0 μm at 6 months and 229.9 μm at 1 year (p < 0.001). Reinjection mean number was 0.4 for 6 months and 0.8 for 12 months. By 1year, retreatment was performed in 10 eyes (36%). Conclusions: PDT combined with three consecutive intraviteal bevacizumab injections was effective in improving VA and reducing central macular thickness.
참고문헌 (31)
- Verteporfin in Photodynamic Therapy Study Group, "Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration:two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization--verteporfin in photodynamic therapy report 2", Am J Ophthalmol, 131, pp.541~560 (2001)
- Azab M, "Verteporfin therapy of subfoveal minimally classic choroidal neovascularization in age-related macular degeneration:2-year results of a randomized clinical trial", Arch Ophthalmol, 123, pp.448~457 (2005)
- Bressler NM, "Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin:two-year results of 2 randomized clinical trials-tap report 2", Arch Ophthalmol, 119, pp.198~207 (2001)
- Schmidt-Erfurth U, "Photodynamic effects on choroidal neovascularization and physiological choroid", Invest Ophthalmol Vis Sci, 43, pp.830~841 (2002)
- Matsuoka M, "Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathy", Br J Ophthalmol, 88, pp.809~815 (2004)
- Schmidt-Erfurth U, "Influence of photodynamic therapy on expression of vascular endothelial growth factor(VEGF),VEGF receptor 3,and pigment epithelium-derived factor", Invest Ophthalmol Vis Sci, 44, pp.4473~4480 (2003)
- Schmidt-Erfurth U, "Photodynamic therapy with verteporfin for choroidal neovascularization caused by age-related macular degeneration:results of retreatments in a phase 1 and 2 study", Arch Ophthalmol, 117, pp.1177~1187 (1999)
- Avery RL, "Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration", Ophthalmology, 113, pp.363~372.e5 (2006)
- Spaide RF, "Intravitreal bevacizumab treatment of choroidal neovascularization secondary to age-related macular degeneration", Retina, 26, pp.383~390 (2006)
- Bashshur ZF, "Intravitreal bevacizumab for the management of choroidal neovascularization in age-related macular degeneration", Am J Ophthalmol, 142, pp.1~9 (2006)
- Costa RA, "Intravitreal bevacizumab for choroidal neovascularization caused by AMD(IBeNA Study):results of a phase 1 dose-escalation study", Invest Ophthalmol Vis Sci, 47, pp.4569~4578 (2006)
- Rich RM, "Short-term safety and efficacy of intravitreal bevacizumab(Avastin)for neovascular age-related macular degeneration", Retina, 26, pp.495~511 (2006)
- Gragoudas ES, "Pegaptanib for neovascular age-related macular degeneration", N Engl J Med, 351, pp.2805~2816 (2004)
- Rosenfeld PJ, "Ranibizumab for neovascular age-related macular degeneration", N Engl J Med, 355, pp.1419~1431 (2006)
- Brown DM, "Ranibizumab versus verteporfin for neovascular age-related macular degeneration", N Engl J Med, 355, pp.1432~1444 (2006)
- Navea A, "One-year follow-up of combined customized therapy.Photodynamic therapy and bevacizumab for exudative age-related macular degeneration", Retina, 29, pp.13~19 (2009)
- Kaiser PK, "Verteporfin photodynamic therapy and anti-angiogenic drugs:potential for combination therapy in exudative age-related macular degeneration", Curr Med Res Opin, 23, pp.477~487 (2007)
- Kaiser PK, "Angiographic and optical coherence tomographic results of the MARINA study of ranibizumab in neovascular age-related macular degeneration", Ophthalmology, 114, pp.1868~1875 (2007)
- Kaiser PK, "Ranibizumab for predominantly classic neovascular age-related macular degeneration:subgroup analysis of first-year ANCHOR results", Am J Ophthalmol, 144, pp.850~857 (2007)
- Treatment of Age-related Macular Degeneration with Photodynamic Therapy(TAP)Study Group, "Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin:one-year results of 2 randomized clinical trials:TAP report", Arch Ophthalmol, 117, pp.1329~1345 (1999)
- Lalwani GA, "A variable-dosing regimen with intravitreal ranibizumab for neovascular age-related macular degeneration: year 2 of the PrONTO Study", Am J Ophthalmol, 148, pp.43~58.e1 (2009)
- Rechtman E, "Intravitreal triamcinolone with photodynamic therapy for subfoveal choroidal neovascularisation in age related macular degeneration", Br J Ophthalmol, 88, pp.344~347 (2004)
- Spaide RF, "Photodynamic therapy with verteporfin combined with intravitreal injection of triamcinolone acetonide for choroidal neovascularization", Ophthalmology, 112, pp.301~304 (2005)
- Danis RP, "Intravitreal triamcinolone acetonide in exudative age-related macular degeneration", Retina, 20, pp.244~250 (2000)
- Spaide RF, "Rationale for combination therapies for choroidal neovascularization", Am J Ophthalmol, 141, pp.149~156 (2006)
- Fung AE, "An optical coherence tomography-guided,variable dosing regimen with intravitreal ranibizumab(Lucentis)for neovascular age-related macular degeneration", Am J Ophthalmol, 143, pp.566~583 (2007)
- Benjamin LE, "Selective ablation of immature blood vessels in established human tumors follows vascular endothelial growth factor withdrawal", J Clin Invest, 103, pp.159~165 (1999)
- Heier JS, "Ranibizumab combined with verteporfin photodynamic therapy in neovascular age-related macular degeneration:year 1 results of the FOCUS Study", Arch Ophthalmol, 124, pp.1532~1542 (2006)
- Smith BT, "Intravitreal injection of bevacizumab combined with verteporfin photodynamic therapy for choroidal neovascularization in age-related macular degeneration", Retina, 28, pp.675~681 (2008)
- Isola V, "Choroidal ischemia after photodynamic therapy with verteporfin for choroidal neovascularization", Am J Ophthalmol, 142, pp.680~683 (2006)
- Augustin AJ, "Triple therapy for choroidal neovascularization due to age-related macular degeneration:verteporfin PDT,bevacizumab,and dexamethasone", Retina, 27, pp.133~140 (2007)
