Photodynamic therapy combined with intravitreal bevacizumab for the management of choroidal neovascularization resistant to bevacizumab monotherapy. a case series Terapia fotodinámica combinada con bevacizumab intravítreo para el tratamiento de neovascularización coroidea refractaria a tratamiento con monoterapia con bevacizumab, Serie de casos
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© 2018 Sociedad Mexicana de Oftalmología. Published by Permanyer México SA de CV. Purpose: To evaluate the clinical response of treatment-resistant choroidal neovascularization (CNV) to photodynamic therapy (PDT) combined with bevacizumab (BVZ) therapy. Methods: Retrospective, non-comparative evaluation of eyes diagnosed with CNV secondary to age-related macular degeneration that had no response after at least 3 intravitreal BVZ injections, who were treated with combined PDT therapy, followed by subsequent monthly BVZ for a 6 months period. Main outcome measures were best-corrected visual acuity (BCVA) and central macular thickness (CMT) during a 6 month follow-up period after combined therapy. Results: Eleven patients (54.5% female, mean age 62 years) were included. Using ICG angiography, lesions were classified as polypoidal choroidal vasculopathy (PCV) 54.5%, arteriolized CNV 18.2% (2), and non-differentiable 27.3% (3). BCVA (logMAR) at baseline was 0.63 (20/85), increasing to 0.32 (20/40) 6 months after treatment (p = 0.04). Mean CMT before the intervention was 469 ¿m, decreasing to 289 ¿m 6 months after treatment (p = 0.01). Conclusion: Combined PDT therapy appears to be effective in treatment-resistant CNV, with an improvement of BCVA and CMT after a 6-month period that was not observed with BVZ monotherapy. A high incidence of PCV and arteriolized CNV was observed in this group or treatment-resistant CNV cases. Terapia fotodinámica combinada con bevacizumab intravítreo para el tratamiento de neovascularización coroidea refractaria a tratamiento con monoterapia con bevacizumab, Serie de casos.