Combined Intravitreal Bevacizumab and Photodynamic Therapy for Retinal Angiomatous Proliferation

Purpose: To clarify the efficiency of combined therapy with intravitreal bevacizumab injections and photodynamic therapy (PDT) in patients with retinal angiomatous proliferation (RAP). Design: Retrospective, observational, consecutive case series. Methods: We retrospectively reviewed 11 consecutive eyes with RAP (10 patients; six men, four women) treated with intravitreal bevacizumab injection and PDT. Patients ranged in age from 63 to 89 years old (average, 79 years). No patients had undergone previous treatment, and patients were followed for at least six months. PDT was applied one or two days after the intravitreal bevacizumab (1.25 mg) injection. Results: The mean best-corrected visual acuity (BCVA) levels at baseline and one, three, and six months after treatment were 0.16, 0.27, 0.31, and 0.29, respectively. A significant improvement in the mean BCVA was observed one, three, and six months after intravitreal bevacizumab injection and PDT (P < .01). The mean improvement in BCVA six months from baseline was 2.64 lines. The BCVA at six months improved in six eyes (54.5%, improved by three lines or more) and was stable in five eyes (45.5%). No patient had a decrease in the BCVA of three or more lines during any six months. The central retinal thickness significantly decreased from 496 ± 189 μm to 175 ± 33 μm at six months (P < .001). No patients required retreatment during any six months. No complications such as severe vision loss, endophthalmitis, or systemic events developed. Conclusion: Combined intravitreal bevacizumab and PDT for RAP effectively maintained or improved VA and reduced or eliminated edema in the short-term.