Prospective Comparison of Low-Fluence Photodynamic Therapy Combined with Intravitreal Bevacizumab versus Bevacizumab Monotherapy for Choroidal Neovascularization in Age-Related Macular Degeneration

Purpose: To evaluate combination treatment with reduced-fluence photodynamic therapy (RDPDT) with Verteporfin and intravitreal bevacizumab, compared to bevacizumab alone, for choroidal neovascularization (CNV) in age-related macular degeneration. Methods: This was a prospective, randomized comparative study comprising 95 patients with CNV. 49 patients received RDPDT (25 J/cm(2)) followed by intravitreal bevacizumab 1.25mg one hour later, while 46 received intravitreal bevacizumab alone. Patients were followed for 12 months at four-week intervals with visual acuity (VA) assessment and Optical Coherence Tomography (OCT) of the macula. Bevacizumab re-injections were performed as needed. Results: On average, patients were re-injected 4.45 times in the combination group and 6.96 times in the bavacizumab group (p<0.001). At 12 months, VA improved by 8.64 letters in the bevacizumab group and by 8.37 letters in the combination group (p = 0.922). Conclusion: Adding a reduced-fluence PDT arm in combination with bevacizumab offers similar results to those of intravitreal bevacizumab alone with significantly reduced number of injection repetitions.