MyVisionTest News Archive
Jun 15, 2009
Combined anti-VEGF and PDT for nonfoveal choroidal neovascularization
A new study finds that combined anti-VEGF and photodynamic therapy (PDT) is effective for juxtafoveal and extrafoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD), ocular histoplasmosis syndrome (OHS), and degenerative myopia.
Laser photocoagulation is the standard therapy for CNV that occurs outside the central macular region ("extrafoveal") or adjacent to the central macula ("juxtafoveal"), but is associated with a large dense residual scotoma following successful treatment. The safety and effectiveness of anti-VEGF drugs and PDT has not yet been tested with randomized clinical trials for treating CNV in these regions of the retina. However, small case series have reported favorable results as an alternative to traditional laser photocoagulation of nonfoveal CNV.
A total of 10 eyes with juxtafoveal or extrafoveal CNV underwent intravitreal anti-VEGF therapy combined with verteporfin PDT. Most treatments consisted of PDT every 12 weeks and either Lucentis (ranibizumab) 0.5 mg every 4 weeks or Avastin (bevacizumab) 1.25 mg every 6 weeks, initiated concurrently. Retreatment criteria were persistent exudative signs on optical coherence tomography or fluorescein angiography.
Baseline visual acuity (VA) ranged from 20/20 to 20/60 (mean logMAR, 0.338). After a mean follow-up of 17.5 months, it ranged from 20/15 to 20/40 (mean logMAR, 0.150; P=0.027). Six eyes improved by 2 lines and four remained within 2 lines of initial VA. Non-AMD eyes required much fewer treatments than AMD eyes. All five non-AMD eyes and three of five AMD eyes showed no CNV activity at least 5 months after last treatment.
The investigators conclude that combined anti-VEGF therapy and PDT can preserve good visual function and may be suited to some cases of nonfoveal CNV. AMD eyes require longer courses of treatment than non-AMD eyes.
Read more...
Eye. 2009 Jun 5. [Epub ahead of print]
Tags: Avastin, photodynamic therapy, wet AMD, myopia, histoplasmosis, Lucentis, laser photocoagulation
A new study finds that combined anti-VEGF and photodynamic therapy (PDT) is effective for juxtafoveal and extrafoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD), ocular histoplasmosis syndrome (OHS), and degenerative myopia.Laser photocoagulation is the standard therapy for CNV that occurs outside the central macular region ("extrafoveal") or adjacent to the central macula ("juxtafoveal"), but is associated with a large dense residual scotoma following successful treatment. The safety and effectiveness of anti-VEGF drugs and PDT has not yet been tested with randomized clinical trials for treating CNV in these regions of the retina. However, small case series have reported favorable results as an alternative to traditional laser photocoagulation of nonfoveal CNV.
Baseline visual acuity (VA) ranged from 20/20 to 20/60 (mean logMAR, 0.338). After a mean follow-up of 17.5 months, it ranged from 20/15 to 20/40 (mean logMAR, 0.150; P=0.027). Six eyes improved by 2 lines and four remained within 2 lines of initial VA. Non-AMD eyes required much fewer treatments than AMD eyes. All five non-AMD eyes and three of five AMD eyes showed no CNV activity at least 5 months after last treatment.
The investigators conclude that combined anti-VEGF therapy and PDT can preserve good visual function and may be suited to some cases of nonfoveal CNV. AMD eyes require longer courses of treatment than non-AMD eyes.
Read more...
Eye. 2009 Jun 5. [Epub ahead of print]
