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AbstractFR.13.03 Comparison between intravitreal Avastin monotherapy and combined treatment with photodynamic therapy for neovascular AMD Eter N.1, Wachtlin J.2, Meyer C. H.1, Ladewig M.3, Hamelmann V.1, Holz F. G.1 for the Avastin Study Group
1Department of Ophthalmology, University of Bonn; 2Charité, Campus Benjamin Franklin, Berlin; 3Klinikum Saarbrücken Objective: To evaluate efficacy, safety and retreatment rate of same-day administration of intravitreal Avastin (IVA) and photodynamic therapy (PDT) compared to IVA monotherapy in patients with neovascular age-related macular degeneration (AMD).
Methods: Treatment and follow-up data of patients receiving at least one IVA injection for wet AMD was collected in a database. 935 files from 11 centers (304 predominantly classic, 70 minimally classic, and 561 occult CNV subtypes) were available for evaluation. All patients received at least one injection of 1.25 1.5 mg Avastin (Bevacizumab). 166 of these were also treated with PDT the same day. Before treatment and during follow-up ETDRS visual acuity or LogMAR visual acuity was determined and patients were examined by optical coherence tomography (OCT), and if necessary with fluorescein angiography (FA).
Results: Mean retinal thickness on OCT decreased by 138 and 160 µm in the combination treatment group and by 45 and 79 µm in the Avastin monotherapy group 6 and 9 months after treatment (p=0.004; p=0.12). No intraocular inflammation occurred. Patients in the combination treatment group received an average of 0.35 injections per month, while patients in the monotherapy group were treated with an average of 0.57 injections per month (p<0.001). 88.1% and 86.8% of monotherapy patients and 77.1% and 71.4% of combination treatment patients lost less than 15 ETDRS letters 6 and 9 months after their first treatment (p>0.05).
Conclusions: The present results indicate that same-day combination of PDT and intravitreal Avastin reduces the retreatment rate. Further subgroup evaluation will have to address the discrepancy between better morphologic and less optimal functional results in the combination treatment group compared to the monotherapy group.
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