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PDT not as effective for myopic choroidal neovascularization as anti-VEGF monotherapy

Retina. 2010;30(3):418-424.

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Anti-VEGF monotherapy appears to improve visual acuity in patients with myopic choroidal neovascularization compared with photodynamic therapy or combination therapy.

In a study of 142 eyes of 128 consecutive patients, the addition of an anti-VEGF agent — either Lucentis (ranibizumab, Genentech) or Avastin (bevacizumab, Genentech) — to PDT improved visual acuity compared with baseline more so than laser alone, but results were more robust after anti-VEGF therapy alone.

In the 63 eyes that underwent anti-VEGF monotherapy, visual acuity improved from 0.57 logMAR to 0.33 logMAR at 12 months, and there was a statistically significant improvement at 3, 6 and 9 months as well.

"The PDT and combination groups showed no significant visual change from baseline visual acuity at any follow-up visit," the study authors said.

Overall, 98.4% of patients in the monotherapy group, 92.8% in the combination therapy group and 72.6% in the laser group lost less than 15 letters; 39.7% of monotherapy patients, 21.4% of combination therapy patients and 17.7% of PDT patients improved by 15 letters or more from baseline to the end of the study.

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