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Anti-VEGF monotherapy may improve visual acuity more effectively than PDT combined with anti-VEGF
Retina. 2011;31(4):636-644.
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A study suggested that ranibizumab monotherapy may improve visual acuity to a greater extent than verteporfin photodynamic therapy in combination with ranibizumab for patients with neovascular age-related macular degeneration.
The open-label, prospective study included 20 eyes of 17 patients assigned to Lucentis (ranibizumab, Genentech) monotherapy and 20 eyes of 13 patients assigned to PDT with Visudyne (verteporfin, Novartis) in combination with intravitreal ranibizumab. Follow-up was 1 year.
Eyes in the monotherapy group received three monthly, consecutive ranibizumab injections, while eyes in the combination therapy group received a single session of verteporfin PDT with ranibizumab. Patients in each group were given as-needed ranibizumab injections during follow-up.
Although anatomical improvement was similar for the two groups, mean gain in visual acuity was 12 letters for the monotherapy group and 3.2 letters for the combination therapy group. Only one eye in the combination group lost more than 15 letters.
Despite better visual acuity outcomes, the monotherapy group was associated with a shorter interval between initial treatment and re-treatment, as well as more ranibizumab injections during re-treatment.
The study authors encouraged larger trials with longer follow-up to confirm these findings.