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

M. Rinaldi, F. Semeraro, F. Chiosi, A. Russo, M. R. Romano, M. C. Savastano, R. Dell’Omo, C. Costagliola

Research output: Contribution to journalArticle

Abstract

Background: 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. Methods: Sixty patients affected by myopic CNV (mCNV) were randomized to receive either ranibizumab 0.5 mg 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 48 weeks. Results: Mean BCVA change at 48 weeks was + 0.2 and +15 letters with SF or RFPDT plus ranibizumab, respectively, compared with +16.8 letters with RM. At 48 weeks, mean central foveal thickness (CFT) decrease from baseline was 58 ± 15 μm, 91.4 ± 43.8 μm, and 85 ± 41.5 μm for the verteporfin SF, RF and RM groups, respectively. Macular sensitivity improvement was + 0.4 db, + 1.9 dB and + 2.7 dB for the verteporfin SF, RF and RM groups, respectively. Conclusions: 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 48 weeks. Among all groups, the RF-PDT seemed to reduce the number of ranibizumab retreatments.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
DOIs
Publication statusAccepted/In press - Sep 28 2016

Fingerprint

Choroidal Neovascularization
Myopia
Photochemotherapy
Retreatment
Ranibizumab
verteporfin
1-phenyl-3,3-dimethyltriazene

Keywords

  • Choroidal neovascularization
  • Microperimetry
  • Pathologic myopia
  • Ranibizumab
  • Reduced-fluence verteporfin photodynamic therapy

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Reduced-fluence verteporfin photodynamic therapy plus ranibizumab for choroidal neovascularization in pathologic myopia. / Rinaldi, M.; Semeraro, F.; Chiosi, F.; Russo, A.; Romano, M. R.; Savastano, M. C.; Dell’Omo, R.; Costagliola, C.

In: Graefe's Archive for Clinical and Experimental Ophthalmology, 28.09.2016, p. 1-11.

Research output: Contribution to journalArticle

Rinaldi, M. ; Semeraro, F. ; Chiosi, F. ; Russo, A. ; Romano, M. R. ; Savastano, M. C. ; Dell’Omo, R. ; Costagliola, C. / Reduced-fluence verteporfin photodynamic therapy plus ranibizumab for choroidal neovascularization in pathologic myopia. In: Graefe's Archive for Clinical and Experimental Ophthalmology. 2016 ; pp. 1-11.
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AU - Semeraro, F.

AU - Chiosi, F.

AU - Russo, A.

AU - Romano, M. R.

AU - Savastano, M. C.

AU - Dell’Omo, R.

AU - Costagliola, C.

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N2 - Background: 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. Methods: Sixty patients affected by myopic CNV (mCNV) were randomized to receive either ranibizumab 0.5 mg 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 48 weeks. Results: Mean BCVA change at 48 weeks was + 0.2 and +15 letters with SF or RFPDT plus ranibizumab, respectively, compared with +16.8 letters with RM. At 48 weeks, mean central foveal thickness (CFT) decrease from baseline was 58 ± 15 μm, 91.4 ± 43.8 μm, and 85 ± 41.5 μm for the verteporfin SF, RF and RM groups, respectively. Macular sensitivity improvement was + 0.4 db, + 1.9 dB and + 2.7 dB for the verteporfin SF, RF and RM groups, respectively. Conclusions: 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 48 weeks. Among all groups, the RF-PDT seemed to reduce the number of ranibizumab retreatments.

AB - Background: 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. Methods: Sixty patients affected by myopic CNV (mCNV) were randomized to receive either ranibizumab 0.5 mg 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 48 weeks. Results: Mean BCVA change at 48 weeks was + 0.2 and +15 letters with SF or RFPDT plus ranibizumab, respectively, compared with +16.8 letters with RM. At 48 weeks, mean central foveal thickness (CFT) decrease from baseline was 58 ± 15 μm, 91.4 ± 43.8 μm, and 85 ± 41.5 μm for the verteporfin SF, RF and RM groups, respectively. Macular sensitivity improvement was + 0.4 db, + 1.9 dB and + 2.7 dB for the verteporfin SF, RF and RM groups, respectively. Conclusions: 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 48 weeks. Among all groups, the RF-PDT seemed to reduce the number of ranibizumab retreatments.

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