Comparative study of photodynamic therapy monotherapy versus triple management in age-related macular degeneration

Aim: To compare the effectiveness of photodynamic therapy (PDT) and PDT combined with intravitreal triamcinolone (IVTA) and vascular endothelial growth factor inhibition (anti-VEGF) in age-related macular degeneration (AMD). Materials and methods: Eighty eyes of 80 patients diagnosed with choroidal neovascularization (CNV) caused by AMD were included in the study. PDT was carried out on 40 eyes in group I, and PDT combined with 4 mg IVTA and anti-VEGF (1.25 mg bevacizumab in 20 eyes, 0.3 mg pegaptanib sodium in 20 eyes) was carried out in group II. The primary efficacy endpoint was the mean change from baseline visual acuity at month 12. Results: Mean follow-up was 14.2 ± 2.18 months in group I and 12.45 ± 2.82 months in group II. In group I there was a 2.88 logMAR line decrease and 1.95 logMAR line increase in group II in vision between pretreatment and 12th month measurements (P 0.05). Mean PDT session was 2.00 in group I and the mean combined treatment session was 1.15 in group II in the 12th month. Conclusion: Combination of IVTA and anti-VEGF with PDT is more effective and safer than PDT monotherapy in the treatment of CNV secondary to AMD. Combination treatment decreases the frequency and number of treatment sessions for an improved visual prognosis.