treatment of retinal pigment epithelial detachment secondary to exudative age-related macular degeneration
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ID: 173196
2018
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Abstract
Purpose: This pilot study evaluated the combination of photodynamic therapy (PDT) and anti-vascular endothelial growth factor (anti-VEGF) as a treatment in patients with a pigment epithelial detachment (PED) due to exudative age-related degeneration (AMD).
Methods: We analyzed seven consecutive patients between September 1, 2015 and September 1, 2017 with a PED secondary to exudative AMD who were treated with full fluence standard PDT and a series of monthly intravitreal anti-VEGF injections. Follow-up ranged between 3 and 24 months. Variables collected for the purpose of this study included baseline best-corrected visual acuity converted to logMAR (logarithm of minimum angle of resolution), central macular thickness, and maximum PED height. This information was then reviewed at subsequent follow-ups.
Results: The PED completely resolved in 4/7 eyes while three patients had a significant improvement in PED size with a corresponding improvement in visual acuity. Initial PED heights ranged from 147 to 423 μm and was reduced by an average of 255.7 μm (83.2% average reduction, range −143 to - 405 μm). Initial CMT ranged from 223 to 719 μm and was reduced by an average of 225.7 μm (54.4% average reduction, range −88 to - 529 μm). Mean logMAR VA improved from 0.669 (Snellen equivalent 20/93, [20/40 to 20/200]) to 0.269 (Snellen equivalent 20/37, [20/25 to 20/80]) at last follow-up. No complications were observed in our patients.
Conclusions and Importance: PED in the setting of exudative AMD showed an excellent response to a combined multimodal approach that includes PDT with intravitreal anti-VEGF injection followed by a monthly anti-VEGF schedule. Most importantly, visual acuity showed a significant improvement from baseline. If confirmed by future studies, this would offer another treatment avenue for this difficult-to-treat consequence of exudative AMD.
| Reference Key |
gonzalez2018americantreatment
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| Authors | ;Andres Gonzalez;Gibran Khurshid |
| Journal | contemporary clinical trials communications |
| Year | 2018 |
| DOI |
10.1016/j.ajoc.2017.12.004
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