Terapia combinata con fotodinamica-verterporfirina e ranibizumab intravitreale per il trattamento della Retinal Angiomatous Proliferation correlata alla degenerazione maculare senile.

Purpose : to evaluate the efficacy and safety of the combination of Photodynamic Therapy (PDT) with standard fluence verteporfin and Ranibizumab 0.5mg administered on the same day, in patients with the neovascolar AMD (Aged Macular Degeneration) known as RAP (Retinal angiomatous proliferation ). Type of study : open-label, monocentric, randomized case series trial. Methods: 6 eyes of 6 patients were consecutively enrolled and treated with combined therapy defined as standard fluence PDT and intravitreal Ranibizumab 0.5mg on the same day. More injection were administrated as needed.Best corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography (OCT) and Fluorescein angiography (FA) were examined before and after treatment every 4 weeks. Patients were followed-up for twelve months. Results: the mean baseline BCVA (± standard deviation, SD) was 27,8 (LogMar 0,576)(±14,6) (p=), at 12 months after treatment mean BCVA was 33,3 (LogMar 0,466 )(±16,6) (p=). The mean CMT at baseline was 393,8µm (±82,4) (p=) at 12 months was 250,7 µm (±82,4) (p=). The mean reduction was 142,2 µm. At 12 months in 4 eyes (66,6%) there was the absence of leakage on FA . After 12 months, the rate of retreated eyes was 33,3 % (2 of 6 eyes). Discussion and Conclusion: In conclusion the treatment shows a functional and anatomical improvement since the first month after treatment. OCT shows this improvement as a great reduction of intraretinal edema. No ocular or systemic adverse effects from treatment were encountered