Anti-VEGF therapy improves vision less following PDT

[MyVisionTest]

The vision of patients with persistent or reactivated choroidal
neovascularization (CNV) that had been previously treated with
photodynamic therapy (PDT) improve less than treatment-naive patients.

Baseline assessments including best-corrected visual acuity,
fluorescein angiography (FFA), and optical coherent tomography (OCT)
were performed. Intravitreal Lucentis (ranibizumab) and/or Avastin
(bevacizumab) were administered on an as-needed basis, guided by
changes in visual outcome and OCT findings. The follow-up period was
at least 6 months.

Twenty-five subjects with predominantly classic CNV, previously
treated with PDT (mean 1.84 PDT sessions) showed reactivation or
persistent CNV. The mean interval between PDT and intravitreal
anti-VEGF treatment was 18.32 months (1–48 months); and patients
received an average of 3.2 injections over a 6-month period. The mean
change of visual acuity following PDT was -10.12 Early Treatment
Diabetic Retinopathy Study (ETDRS) letters (54.3615.79–44.2417.32
letters). Following anti-VEGF therapy, the mean change in visual
acuity at 3 and 6 months were +1.76 and +0.72, respectively. The
proportion of subjects with stable vision (loss of 15 letters) was 96%
at 3 months and 88% at 6 months; the proportion of subjects who showed
improved vision (15 letters) was 8% at 3 months and 4% at 6 months.

Anti-VEGF agents stabilised the visual outcomes of eyes previously
treated with PDT. However, the proportion of patients who showed
improved vision in this group was smaller than the proportion reported
in subjects with treatment-naive lesions.

Eye (Lond). 2009 Nov 6. [Epub ahead of print]

http://www.ncbi.nlm.nih.gov/pubmed/19893588

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