Ranibizumab in combination with verteporfin photodynamic therapy is more effective compared with ranibizumab monotherapy in patients with polypoidal choroidal vasculopathy, according to a study published in JAMA Ophthalmology.
In this multicenter, randomized clinical trial (EVEREST II), 322 patients with symptomatic macular polypoidal choroidal vasculopathy were randomized to receive ranibizumab (0.5 mg) in combination with verteporfin photodynamic therapy (n = 168) or ranibizumab (0.5 mg) plus sham photodynamic therapy (n = 154). Ranibizumab injections were given for monthly for 3, followed by a pro re nata regimen.
Verteporfin photodynamic therapy or sham photodynamic therapy were given on day 1, and pro re nata regimen based on the presence of active polypoidal lesions afterward.
After 2 years, the adjusted mean best-corrected visual acuity (BCVA) gains were 9.6 letters in the combination therapy group and 5.5 letters in the monotherapy group. Up to 24 months, participants in the combination group received fewer ranibizumab injections than the monotherapy group.
A median of 2 verteporfin photodynamic therapy treatments at 24 months were need in the combination group, with 44.6% requiring only 1 treatment.
Lim TH, Lai TYY, Takahashi K, et al. Comparison of ranibizumab with or without verteporfin photodynamic therapy for polypoidal choroidal vasculopathy. JAMA Ophthalmol. Published online July 16, 2020. doi:10.1001/jamaophthalmol.2020.2443