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Efficacy of intravitreal bevacizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy.
Am J Ophthalmol 2010; 150(1):48-54.e1AJ

Abstract

PURPOSE

To compare the efficacy of photodynamic therapy (PDT) with or without intravitreal bevacizumab injection for polypoidal choroidal vasculopathy.

DESIGN

Retrospective, comparative, interventional case series.

METHODS

We included 146 eyes of 146 patients with treatment-naïve polypoidal choroidal vasculopathy including the subfoveal region treated with PDT monotherapy or combined with intravitreal bevacizumab injection. Treatments were chosen according to the time period. For eyes that received combination therapy, bevacizumab (1.25 mg) was administrated 1 day before PDT. All eyes were followed up for at least 12 months. Ophthalmic evaluations, including measurement of the best-corrected visual acuity and optical coherence tomography, were performed at every visit. Indocyanine green angiography and fluorescein angiography were performed every 3 months.

RESULTS

Sixty-one eyes were treated with PDT combined with bevacizumab and 85 eyes were treated with PDT monotherapy. The mean best-corrected visual acuity was significantly better in the combined treatment group than in the monotherapy group at 3 months (P = .0016), 6 months (P = .028), 9 months (P = .038), and 12 months (P = .048). However, lesions resolved in 78.7% of eyes in the combined group and in 75.3% in the monotherapy group; the recurrence rates were 43.8% and 40.6%, respectively, and did not differ significantly. The rate of development of subretinal hemorrhage within 1 month from the initial treatment was significantly lower in the combined group than in the PDT monotherapy group (4.5% vs 17.7%; P = .023).

CONCLUSIONS

Photodynamic therapy combined with bevacizumab injection offers significantly better early visual outcomes than PDT alone. Combined treatment did not affect the resolution and recurrence of lesions; however, it decreased the rate of development of PDT-related hemorrhages.

Authors+Show Affiliations

Department of Ophthalmology, Osaka University Medical School, Japan. fgomi@ophthal.med.osaka-u.ac.jp <fgomi@ophthal.med.osaka-u.ac.jp>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20609707

Citation

Gomi, Fumi, et al. "Efficacy of Intravitreal Bevacizumab Combined With Photodynamic Therapy for Polypoidal Choroidal Vasculopathy." American Journal of Ophthalmology, vol. 150, no. 1, 2010, pp. 48-54.e1.
Gomi F, Sawa M, Wakabayashi T, et al. Efficacy of intravitreal bevacizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2010;150(1):48-54.e1.
Gomi, F., Sawa, M., Wakabayashi, T., Sasamoto, Y., Suzuki, M., & Tsujikawa, M. (2010). Efficacy of intravitreal bevacizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy. American Journal of Ophthalmology, 150(1), pp. 48-54.e1. doi:10.1016/j.ajo.2010.02.008.
Gomi F, et al. Efficacy of Intravitreal Bevacizumab Combined With Photodynamic Therapy for Polypoidal Choroidal Vasculopathy. Am J Ophthalmol. 2010;150(1):48-54.e1. PubMed PMID: 20609707.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of intravitreal bevacizumab combined with photodynamic therapy for polypoidal choroidal vasculopathy. AU - Gomi,Fumi, AU - Sawa,Miki, AU - Wakabayashi,Taku, AU - Sasamoto,Yuzuru, AU - Suzuki,Mihoko, AU - Tsujikawa,Motokazu, PY - 2009/11/10/received PY - 2010/02/01/revised PY - 2010/02/03/accepted PY - 2010/7/9/entrez PY - 2010/7/9/pubmed PY - 2010/7/28/medline SP - 48 EP - 54.e1 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 150 IS - 1 N2 - PURPOSE: To compare the efficacy of photodynamic therapy (PDT) with or without intravitreal bevacizumab injection for polypoidal choroidal vasculopathy. DESIGN: Retrospective, comparative, interventional case series. METHODS: We included 146 eyes of 146 patients with treatment-naïve polypoidal choroidal vasculopathy including the subfoveal region treated with PDT monotherapy or combined with intravitreal bevacizumab injection. Treatments were chosen according to the time period. For eyes that received combination therapy, bevacizumab (1.25 mg) was administrated 1 day before PDT. All eyes were followed up for at least 12 months. Ophthalmic evaluations, including measurement of the best-corrected visual acuity and optical coherence tomography, were performed at every visit. Indocyanine green angiography and fluorescein angiography were performed every 3 months. RESULTS: Sixty-one eyes were treated with PDT combined with bevacizumab and 85 eyes were treated with PDT monotherapy. The mean best-corrected visual acuity was significantly better in the combined treatment group than in the monotherapy group at 3 months (P = .0016), 6 months (P = .028), 9 months (P = .038), and 12 months (P = .048). However, lesions resolved in 78.7% of eyes in the combined group and in 75.3% in the monotherapy group; the recurrence rates were 43.8% and 40.6%, respectively, and did not differ significantly. The rate of development of subretinal hemorrhage within 1 month from the initial treatment was significantly lower in the combined group than in the PDT monotherapy group (4.5% vs 17.7%; P = .023). CONCLUSIONS: Photodynamic therapy combined with bevacizumab injection offers significantly better early visual outcomes than PDT alone. Combined treatment did not affect the resolution and recurrence of lesions; however, it decreased the rate of development of PDT-related hemorrhages. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/20609707/Efficacy_of_intravitreal_bevacizumab_combined_with_photodynamic_therapy_for_polypoidal_choroidal_vasculopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(10)00115-7 DB - PRIME DP - Unbound Medicine ER -