COMBINATION PHOTODYNAMIC THERAPY AND INTRAVITREAL RANIBIZUMAB IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION IN A NORTH INDIAN POPULATION

In Brief Purpose: To evaluate photodynamic therapy (PDT) with verteporfin along with intravitreal ranibizumab in treatment of neovascular age-related macular degeneration. Methods: This prospective interventional care series included 16 patients (17 eyes) of choroidal neovascularization secondary to neovascular age-related macular degeneration who were treated with PDT with verteporfin followed by an injection of 0.5 mg ranibizumab on the same day. The main outcome measures were best corrected visual acuity as recorded by both Snellen and Early Treatment Diabetic Retinopathy Study (ETDRS) charts (logMAR), contrast sensitivity (Pelli-Robson Chart), retreatment frequency, and frequency of side effects. Results: Seventeen eyes underwent PDT with verteporfin and intravitreal 0.5 mg ranibizumab, following PDT. Patients were followed up every month for a total period of 6 months. Initial visual acuity ranged from CF to 20/32 and final acuity ranged from CF to 20/20. Visual acuity stabilized (gain/loss <2 lines) in 14 out of 17 eyes (82.35%) and improved in 3 out of 17(17.65%). Contrast sensitivity improved in 15 out of17 eyes (82.24%) There were no cases of ocular/systemic adverse events. Retreatment was required in only 2 out of 17 cases (11.76%) with a single injection of intravitreal ranibizumab. Conclusion: The combination of PDT with intravitreal ranibizumab improves contrast sensitivity and stabilizes vision and reduces the number of retreatments, without significant ocular/systemic risks. Following combination therapy with PDT and Ranibizumab for Neovascular AMD in a select North Indian population, results at six months follow up showed stabilization of vision in 14 out of 17 eyes (82.35%), while contrast sensitivity improved in 15 out of 17 eyes (82.24%). Retreatment was required in only 2 out of 17 eyes (11.76%). The combination of PDT with intravitreal Ranibizumab, improved contrast sensitivity, stabilized vision and markedly reduced the number of retreatments, with out side-effects.