Rescue photodynamic therapy for age-related macular degeneration refractory to anti-vascular endothelial growth factor monotherapy.

Abstract

BACKGROUND:

To evaluate the 3-year outcome in eyes with neovascular age-related macular degeneration (nAMD) treated with intravitreal anti-vascular endothelial growth factor monotherapy or rescue therapy using standard verteporfin photodynamic therapy (PDT), and corroborate efficacy of rescue PDT.

METHODS:

Patients were administered aflibercept injections once a month for 3 months followed by once every 2 months in the first year. After year 1, treatment with aflibercept monotherapy as indicated or in combination with PDT at the retinal specialist's discretion. Only cases completing the three-year follow-up were included. Regression analysis with visual acuity and macular atrophy at year 3 was performed for the dependent variable.

RESULTS:

Of the 292 eyes, 15 eyes underwent rescue PDT following year 1. The best-corrected visual acuity (logarithm of minimal angle of resolution, mean/Snellen equivalent ± SD) was 0.35 (20/45) ± 0.38, 0.23 (20/30) ± 0.36, 0.26 (20/35) ± 0.38, and 0.31 (20/40) ± 0.42 at baseline, year 1, year 2, and year 3, respectively. Multiple regression analysis revealed that the rescue PDT was significantly associated with macular atrophy and poor visual outcome at year 3 (odds ratio = 1.2, p < 0.001; β = 0.23, p = 0.0029, respectively).

CONCLUSIONS:

The visual outcome in eyes with nAMD retained baseline levels at year 3; however, patients treated with rescue PDT developed macular atrophy more frequently and poor visual outcomes.

• Authors: Miyo Yoshida, Akio Oishi, Masahiro Miyake, Sotaro Ooto, Hiroshi Tamura, Manabu Miyata, Ayako Takahashi, Masayuki Hata, Kenji Yamashiro, Akitaka Tsujikawa
• Journal: Photodiagnosis and photodynamic therapy (Photodiagnosis Photodyn Ther) Vol. 38 Pg. 102745 (Jun 2022) ISSN: 1873-1597 [Electronic] Netherlands
• PMID: 35123015 (Publication Type: Journal Article)
• Copyright: Copyright © 2022. Published by Elsevier B.V.

Chemical References

• Angiogenesis Inhibitors
• Vascular Endothelial Growth Factor A
• Vascular Endothelial Growth Factors

Topics

• Angiogenesis Inhibitors (therapeutic use)
• Atrophy (chemically induced, complications, drug therapy)
• Fluorescein Angiography
• Humans
• Intravitreal Injections
• Macular Degeneration (drug therapy)
• Photochemotherapy (methods)
• Tomography, Optical Coherence
• Treatment Outcome
• Vascular Endothelial Growth Factor A
• Vascular Endothelial Growth Factors