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This abstract is assigned to session SBO-BOG Free papers: Medische retina en oculaire inflammatie /Rétine médicale et inflammation oculaire

Title

Reduced-fluence rate PDT and ranibizumab in neovascular AMD

Purpose	Combined PDT and anti-angiogenics have been shown to be safe and efficacious for wet AMD. We investigated the safety and efficacy of reduced-fluence rate PDT and ranibizumab, and also determined whether this decreases the frequency of reinjections as compared to ranibizumab monotherapy.
Methods	Twenty-eight consecutive patients (30 eyes) presenting with active, untreated wet AMD were enrolled in a prospective trial. Occult CNV was present in 67%; RAP lesions were present in 23%. The remaining 3 eyes had classic, predominantly classic and minimally classic CNV. All patients received same-day reduced-fluence rate PDT and intravitreal ranibizumab. A second and third ranibizumab injection was given at weeks 4 and 8. Patients were examined at week 12 and followed up every 6-8 weeks for 18 months. Additional ranibizumab was given to eyes with active CNV.
Results	Neither systemic side effects nor uveitis were observed. One patient died during the first year; another patient was lost to follow-up after 12 months. Month 18 data are available for 28 eyes (26 patients aged 55-86 years; mean 77). Mean baseline VA was 62 letters (range: 35-85); 18-month VA was 60 letters (23-82), not including one coumarin-treated patient with vitreous hemorrhage. VA improved >3 lines in 7% and 1-3 lines in 25%; remained stable in 36%, decreased 1-3 lines in 14% and decreased >3 lines in 18%. Losses of >3 lines were due to vitreous hemorrhage, geographic atrophy, fibrosis, and growth of an initially small CNV lesion. An average of 5.1 injections (range: 3-9) were administered in year 1, and 6.0 injections (3-11) over 18 months.
Conclusion	Same-day PDT and ranibizumab was well tolerated. 82% had stable or improved vision at 18 months. Two-year data will be available in February 2009.

Author 1

Last name	SPIELBERG
Initials	L
Department	UZ Leuven
City	Leuven

Author 2

Last name	Leys
Initials	A
Department	UZ Leuven
City	Leuven