One-year results of photodynamic therapy combined with intravitreal ranibizumab for exudative age-related macular degeneration

Abstract

Purpose. To evaluate the effects of photodynamic therapy (PDT) combined with intravitreal injection of ranibizumab (IVR) for exudative age-related macular degeneration (AMD). Methods. Retrospective case series. Thirty eight eyes of 38 patients with exudative AMD underwent combined therapy consisting first of IVR, followed by PDT within a week and the second IVR at 1 month. All patients were followed up for more than 12 months. The best corrected visual acuity (BCVA) and central macular thickness (CMT) were examined. Results. The mean number of IVR and PDT sessions were 2.9 ± 1.3 and 1.1 ± 0.3, respectively. The mean BCVA and CMT were significantly improved to 0.38 logMAR units (P < 0.01) and 240 μm (P < 0.01) at 12 months, respectively. Thirty-six of 38 eyes (94.8%) improved or maintained BCVA at 12 months. Conclusion. PDT combined with IVR for exudative AMD was effective at improving visual acuity and CMT with a low recurrence rate for 12 months.

Figure 1

Changes in mean best corrected visual acuity (BCVA). Visual acuity was expressed as the logarithm of minimal angle of resolution (logMAR). (a) Mean BCVA of all 38 patients in three GLD groups; GLD ≦ 1800 μm, GLD between 1801 and 3500 μm, and GLD between 3501 and 5400 μm. The group of greatest linear dimension (GLD) ≦ 1800 μm showed better BCVA than those of the other 2 groups at all time points. However, there was no significant different among the 3 groups (P > 0.05). (b) Mean BCVA of typical AMD of 24 patients in three GLD groups. (c) Mean BCVA of PCV of 14 patients in 3 GLD groups. Bars indicate standard deviations. *P < 0.05, **P < 0.01; P value for comparison between baseline and each visit. AMD: age-related macular degeneration, PCV: polypoidal choroidal vasculopathy.

Figure 2

Changes in mean central macular thickness (CMT). (a) Mean CMT of all 38 patients in three GLD groups; GLD ≦ 1800 μm, GLD between 1801 and 3500 μm, and GLD between 3501 and 5400 μm. All 3 groups showed similar values among the 3 groups at all time points. (b) Mean CMT of typical AMD of 24 patients. (c) Mean CMT of PCV of 14 patients in 3 GLD groups. There was no significant difference among the three groups (P > 0.05). Bars indicate standard deviations. *P < 0.05, **P < 0.01; P value for comparison between baseline and each visit. AMD: age-related macular degeneration, GLD: greatest linear dimension. PCV: polypoidal choroidal vasculopathy.

Figure 3

Scatter plots showing correlations between visual acuity and grades of the inner and outer segments of the photoreceptors (IS/OS). Visual acuity was expressed as the logarithm of minimal angle of resolution (logMAR). (a) Scatter plot at baseline. There was a significant negative correlation between visual acuity at baseline and IS/OS grade at baseline (Speaman correlation coefficient [r _s] = −0.429; P < 0.01). (b) Scatter plot at 12 months. There was a significant negative correlation between visual acuity at 12 months and IS/OS grade at 12months (r _s = −0.687; P < 0.01).