Comparative study of photodynamic therapy monotherapy versus triplemanagement in age-related macular degeneration

Abstract

Aim: To compare the effectiveness of photodynamic therapy (PDT) and PDT combined with intravitreal triamcinolone (IVTA) and vascular endothelial growth factor inhibition (anti-VEGF) in age-related macular degeneration (AMD).Materials and methods: Eighty eyes of 80 patients diagnosed with choroidal neovascularization (CNV) caused by AMD were included in the study. PDT was carried out on 40 eyes in group I, and PDT combined with 4 mg IVTA and anti-VEGF (1.25 mg bevacizumab in 20 eyes, 0.3 mg pegaptanib sodium in 20 eyes) was carried out in group II. The primary efficacy endpoint was the mean change from baseline visual acuity at month 12.Results: Mean follow-up was 14.2 ± 2.18 months in group I and 12.45 ± 2.82 months in group II. In group I there was a 2.88 logMAR line decrease and 1.95 logMAR line increase in group II in vision between pretreatment and 12th month measurements (P < 0.05). Mean PDT session was 2.00 in group I and the mean combined treatment session was 1.15 in group II in the 12th month. Conclusion:Combination of IVTA and anti-VEGF with PDT is more effective and safer than PDT monotherapy in the treatment of CNV secondary to AMD. Combination treatment decreases the frequency and number of treatment sessions for an improved visual prognosis.

The role of hypoxia-inducible factors in neovascular age-related macular degeneration: a gene therapy perspective

“…Nowadays, nAMD is treated by routine intraocular injections of anti-VEGF agents [77][78][79][80][81][82][83], and to some extent by photodynamic therapy and thermal laser [84,85]. The use of intravitreal anti-VEGF agents has revolutionized the treatment of nAMD with pegaptanib being the first approved anti-VEGF agent.…”

Glucocorticoid therapy and ocular hypertension

“…More recently, GCs has been used in combination with anti-VEGF (Vakalis et al, 2015; Calvo et al; and 2015, Lim et al 2015) or photodynamic monotherapy (Selım et al, 2014). These combinations have been shown to have superior results than either treatment alone.…”

Light-responsive biomaterials for ocular drug delivery

“…Clinical use of this drug product is facilitated by its intravenous infusion using sterile water for injection followed by the application of non-thermal red light. In addition, verteporfin combination with anti-vascular endothelial growth factor therapeutics and steroid drugs like triamcinolone acetonide demonstrated superior efficacy in decreasing the frequency and number of treatment sessions and improved visual prognosis [ 118 , 119 ]. In the same context, loading of a dendritic porphyrin into polyethylene glycol-block-poly(L-lysine) micelles was accomplished in an attempt for age-related macular degeneration treatment.…”