Combined intravitreal bevacizumab and photodynamic therapy with vertiporfin for management of choroidal neovascularization secondary to age-related macular degeneration

Figures & data

Table 1 Patient characteristics and results of combined photodynamic therapy and intravitreal bevacizumab

							Pre-treat. V/A			6-Mo. V/A
Patient	Sex	Age (y)	CNV size (μm)	CNV type	CNV location	No. of retreatment	dicimal	Ft. 20/	LogMAR	dicimal	Ft. 20/	LogMAR	CRT basic (μm)	CRT final (μm)
1	F	70	1,600	PC	SF	1	0.1	200	1	0.2	100	0.7	520	280
2	F	65	2,000	PC	SF	1	0.2	100	0.7	0.32	60	0.5	550	275
3	M	72	2,200	O	SF	1	0.12	160	0.9	0.25	80	0.6	650	240
4	M	80	2,300	PC	JF	2	0.05	400	1.3	0.05	400	1.3	850	400
5	M	65	1,800	O	JF	1	0.1	200	1	0.12	160	0.9	800	270
6	M	62	1,600	PC	SF	1	0.1	200	1	0.1	200	1	800	310
7	F	72	1,400	O	SF	1	0.2	100	0.7	0.32	60	0.5	620	230
8	F	73	2,000	O	JF	1	0.2	100	0.7	0.25	80	0.6	450	250
9	M	75	950	PC	JF	1	0.05	400	1.3	0.5	40	0.3	800	280
10	M	80	850	PC	JF	1	0.25	80	0.6	0.32	60	0.5	450	280
11	M	77	2,000	PC	SF	1	0.1	200	1	0.2	100	0.7	420	250
12	F	80	2,400	O	SF	1	0.1	200	1	0.25	80	0.6	500	230
13	M	70	2,400	PC	SF	1	0.1	200	1	0.2	100	0.7	520	220
14	M	69	3,000	O	SF	2	0.05	400	1.3	0.1	200	1	400	210
15	M	62	2,800	O	SF	2	0.05	400	1.3	0.05	400	1.3	715	320
16	F	80	2,700	PC	JF	1	0.12	160	0.9	0.2	100	0.7	400	270
17	F	82	2,600	PC	SF	1	0.05	400	1.3	0.1	200	1	580	280
18	M	77	2,000	O	JF	1	0.2	100	0.7	0.25	80	0.6	600	220
Mean		72.8	2,033			1.1667	0.11	20/190	0.98	0.18	20/112	0.75	590.278	267.5
SD		6.5	597.29			0.3835	2.4 lines		0.24	2.8 lines		0.277	149.5	45.25

Abbreviations: CRT, central retinal thickness; SD, standard deviation; Ft., feet; CNV, subretinal neovascular membrane; V/A, best corrected visual acuity.

Figure 1 (a) and (a-1) Pretreatment fundus photo and pretreatment FLA, late phase, showing filling of predominantly classic CNV occupying more than 50% of the lesion. Pretreatment BCVA = 20/400. (b) and (b-1) Post-treatment fundus photo and FLA, late phase, at 6 months showing closure of the CNV with only late leakage at its upper temporal edge (BCVA = 20/150). (c) Pretreatment OCT showing CNV with CRT = 558 μm. (c-1) OCT, 6 months post-treatment showing absorption of most of subretinal fluid and reduction of CRT to 248 μm. However, fovea did not return completely to normal configuration.

Abbreviations: BCVA, best corrected visual acuity; CNV, choroidal neovascularization; CRT, central retinal thickness; FLA, fluorescein angiography; OCT, optical coherence tomography.

Figure 2 (a) Pretreatment fundus photo showing juxtafoveal CNV with subretinal hemorrhage occupying about 50% of the lesion (BCVA = 20/400). (a-1) Post-treatment fundus photo at 6 months. Note regression of the membrane and absorption of most subretinal blood (BCVA = 20/40). (b) Pretreatment FLA, showing active CNV. (b-1) Post-treatment FLA showing CNV staining with no leakage. (c) Pretreatment OCT showing the CNV with fluid in the subretinal space (CRT = 800 μm). (d) OCT 6 months post-treatment with almost normal foveal configuration (CRT = 280 μm).

Abbreviations: BCVA, best corrected visual acuity; CNV, choroidal neovascularization; CRT, central retinal thickness; FLA, fluorescein angiography; OCT, optical coherence tomography.

Table 2 Choroidal neovascularization subtype characteristics

Lesion subtype	Mean lesion size (μm)	Patients with stabilization	Patient with visual gaining	Retreatment rate	p value between subgroups†
PC (10)	1,900	20%	80%	20%	p = 0.853
O (8)	2,200	12.5%	87%	12.5%
SF (11)	2,181	18.18%	81.8%	18.18%	p = 0.856
JF (7)	1,800	14.28%	85.7%	14.28%

Abbreviations: PC, predominantly classic; O, occult; SF, subfoveal; JF, juxtafoveal.

† Notes: The difference in visual improvement between different subgroups was statistically insignificant (Student’s t-test for unpaired data).