Effects of combination therapy with verteporfin photodynamic therapy and ranibizumab in patients with age‐related macular degeneration

Purpose: This open‐label, prospective, small‐scale study investigated the benefits of same‐day verteporfin and intravitreal ranibizumab in patients with predominantly classic, minimally classic or occult subfoveal choroidal neovascularization (CNV) secondary to age‐related macular degeneration. Methods: Patients received verteporfin at baseline and at month 3, if leakage persisted. Ranibizumab (0.5 mg) was given at baseline and months 1, 2 and 3, and thereafter at monthly intervals if required. Same‐day ranibizumab was given ≥ 1 hr after verteporfin. Results: Fifteen patients [11 male, four female; mean age 75.5 years (range 54–94 years)] were treated. At day 360, mean visual acuity (VA) had improved by 10.9 letters. An increase of ≥ 15 and ≥ 30 letters (i.e. ≥ 3 and ≥ 6 lines) was observed in seven (47%) patients and one patient (7%), respectively. Mean central retinal thickness (CRT) decreased by 85 μm. At days 7, 14 and 30, CNV perfusion was absent in 14/15 patients. Mean lesion area had reduced from baseline by 23.1% at day 120, 25.5% at day 180 and 23.6% at day 360. There were no visual safety concerns and intraocular pressures remained normal. Only two serious adverse events were recorded over the 12‐month period, and neither was considered to be related to treatment. Conclusion: Same‐day verteporfin plus ranibizumab improved VA, reduced CRT, prevented CNV perfusion and reduced lesion area safely over 12 months. Further investigation is warranted to confirm whether this combination improves long‐term vision and reduces the need for retreatment.