Reduced-fluence verteporfin photodynamic therapy plus ranibizumab for choroidal neovascularization in pathologic myopia.

Abstract

To demonstrate the efficacy of intravitreal ranibizumab (IVR) in combination with reduced-fluence photodynamic therapy (RF-PDT) in patients with choroidal neovascularization (CNV) secondary to pathologic myopia. Sixty patients affected by myopic CNV (mCNV) were randomized to receive either ranibizumab 0.5mg monotherapy (RM; n = 20), standard fluence PDT (SF-PDT, n = 20) or RF-PDT combination therapy (n = 20). Subsequently, IVR was injected as needed. All patients were evaluated for 48weeks. Mean BCVA change at 48weeks was + 0.2 and +15 letters with SF or RFPDT plus ranibizumab, respectively, compared with +16.8 letters with RM. At 48weeks, mean central foveal thickness (CFT) decrease from baseline was 58 ± 15μm, 91.4 ± 43.8μm, and 85 ± 41.5μm for the verteporfin SF, RF and RM groups, respectively. Macular sensitivity improvement was + 0.4db, + 1.9dB and + 2.7dB for the verteporfin SF, RF and RM groups, respectively. Ranibizumab monotherapy or combined with RF-PDT improved BCVA and macular sensitivity in patients affected by mCNV, whereas CFT results were reduced. SF-PDT combination regimen mostly stabilized vision at 48weeks. Among all groups, the RF-PDT seemed to reduce the number of ranibizumab retreatments.