Combined therapy with bevacizumab and photodynamic therapy for myopic choroidal neovascularization: A one-year follow-up controlled study

AIM:Toevaluatetheefficacyandsafetyofacombinedtreatmentformyopicchoroidalneovascularization(CNV)usingphotodynamictherapy(PDT)andintravitrealbevacizumabandtocompareitwithintravitrealbevacizumabmonotherapy.METHODS:Thirty-foureyeswithangiographicevidenceofmyopicCNVwererandomlydividedintotwogroups:17weretreatedwithoneintravitrealbevacizumabinjection(1.25mg)andlow-fluence-ratePDTwithinsevendaysoftheinjection(GroupA).Theother17receivedmonotherapywithbevacizumabinjections(GroupB).Clinicalevidenceofcomplications,bestcorrectedvisualacuity(BCVA)andfluoresceinleakagewereevaluated.BCVAandopticalcoherencetomography(OCT)wereevaluatedmonthly.Thetimepointsfollow-upwasestablishedat6and12mo.AllpatientswereretreatedfollowingaPRNprotocol.RESULTS:Atotalof34eyesof34patients(26womenand8men)withameanageof62.35yearswereincluded.InGroupA(17eyes)themeanBCVAincreasedfrom0.55±0.13logMARbeforethetreatmentto0.40±0.09logMARatthe12mofollow-up(P<0.01).InGroupB(17eyes)themeanBCVAincreasedfrom0.60±0.11logMARbeforethetreatmentto0.55±0.12logMARatthe12mofollow-up(P<0.01).TherewasnostatisticallysignificantdifferencebetweenthetwogroupsintermsofLogMarvisualacuity.InGroupAthemeannumberofcombinedtreatmentswas1.8±0.11perpatient;inGroupBthemeannumberofintravitrealbevacizumabinjectionswas3.1±0.08perpatient.ThenumberoftreatmentswassignificantlyfewerinGroupA(P<0.01).Nolocalorsystemicsideeffectsoccurredamonganyofthepatientstreatedinthisstudy.CONCLUSION:Thecombinationofanti-angiogenicinjectionsandPDTappearstobeasafeandeffectiveoptionformyopicCNVtreatmentandallowsforasignificantreductionofintravitrealinjections.