Randomised clinical trial of intravitreal Avastin vs photodynamic therapy and intravitreal triamcinolone: long-term results

Purpose To compare 1-year functional and anatomic outcomes of intravitreal bevacizumab (IVB) and photodynamic therapy plus intravitreal triamcinolone (PDT + IVTA) combination in patients with neovascular age-related macular degeneration (AMD). Methods In this prospective, randomised, controlled clinical trial, 28 patients were included. All patients were randomised 1 : 1 to 0.04 ml/1 mg of IVB or PDT plus same day 0.1 ml/4 mg IVTA (PDT + IVTA). Follow-up examinations were performed in monthly intervals in IVB group and every 3 months in PDT + IVTA group. Main outcomes were change in mean visual acuity (VA), mean central retinal thickness (CRT) and the mean number of treatments. Results At month 12, mean VA improved to a 1.5-line gain in IVB group, and lost three letters in PDT + IVTA group (P = 0.02). Mean CRT was reduced from 357 mu m at baseline to 244 mu m at month 12 in IVB group and from 326 mu m to 254 mu m, respectively, in PDT + IVTA group (P = 0.8). The mean number of treatments was 6.8 in the IVB group vs 1.9 in the PDT + IVTA group. No significant local or systemic safety concerns were detected during follow-up time. Conclusions Patients treated with IVB showed a significant better VA outcome compared with the PDT + IVTA group despite the fact that both modalities showed equal potency in reducing CRT during a 12-month period. Eye (2009) 23, 2223-2227; doi:10.1038/eye.2008.423; published online 23 January 2009