Abstract
Objective To observe the efficacy of monotherapy and combination treatments of photodynamic therapy (PDT) and intravitreal anti- vascular endothelial growth factor (VEGF) drugs for advanced exudative age-related macular degeneration (EAMD).Methods Thirty-two eyes from 28 patients with EAMD were enrolled in this study.Fifteen eyes were treated with PDT or intravitreal anti-VEGF drugs (monotherapy group),while 17 eyes were treated with combination treatments of PDT and intravitreal anti-VEGF drugs (combination group).The follow-up was ranged from 5 to 28 months with a mean of 21 months.Vision and intraocular pressure were measured and optical coherence tomography (OCT) was performed every month after treatment.Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed every 3 months during follow-up period.The changes of visual acuity,leakage in macula lutea and central retinal thickness (CRT) before and after treatment,and adverse events during follow-up period were observed.The mean treatment times of monotherapy and combination group were compared and analyzed.Results Among 32 eyes,visual acuity improved in 20 eyes (62.5％),stabilized in 9 eyes (28.1％) and decreased in 3 eyes (9.4％).The leakage in macula lutea disappeared in 17 eyes (53.1％),decreased in 12 eyes (37.5％) and increased in 3 eyes (9.4％).CRT was reduced in 23 eyes (71.8％),increased in 9 eyes (28.2％).The mean treatment times of the combination group (2.3±0.2)was significantly less than that of monotherapy group (3.4 ± 0.5)(P＜0.05).No adverse events such as secondary retinal hemorrhage,vitreous hemorrhage or endoophthalmitis were found during the follow-up duration.Conclusions Both monotherapy and combination treatments of PDT and intravitreal anti-VEGF drugs for EAMD may improve visual acuity,exudation and macular edema.Combination of PDT and antiVEGF therapy decreases the frequency of retreatment. Key words: Macular degeneration/ therapy; Choroidal neovascularization/therapy; Antibodies,monoclonal/therapeutic use; Triamcinolone acetonide/therapeutic use; Photochemotherapy
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