28. Combination Therapy of CNV Caused By AMD with
Verteporfin PDT and Bevacizumab:
The Registry of Visudyne® AMD Therapy Database
Paul B. Griggs for the RVT Investigator Group (Seattle)
Purpose: To assess real-world treatment regimens and outcomes for patients with CNV caused
by AMD treated with a combination of verteporfin (Visudyne) PDT and intravitreal bevacizumab.
Methods: Retrospective analysis of patients treated with verteporfin PDT and at least 1 intravitreal
injection of bevacizumab. Physicians entered data into a secure Web-accessed database
after obtaining patient consents and IRB approvals. Inclusion criteria: prior treatment of subfoveal
CNV (classic, occult, or minimally classic) due to AMD with bevacizumab administered
within ±14 days of verteporfin PDT. The study eye could have been previously treated or treatment
naive. Required follow-up data included vision assessment, dilated eye exam, intraocular pressure check, serious
adverse event reporting, and additional treatment(s), if any.
Results: To date, data were entered for 922 patients with at least 3 months of follow-up. At baseline, mean VA was 0.944
logMAR (20/176); 55 % of patients were treatment-naïve. Patients had a mean follow-up of 8.4 months (range 3.0-19.2
months) and received a mean of 0.4 verteporfin PDT treatments and 1.5 bevacizumab treatments beyond their baseline treatments.
At 8 months patients (n=465) gained a mean of 6.7 letters of VA; treatment-naïve patients (n=245) gained a mean of
9.6 letters. The order of treatment did not substantially affect the VA outcome at 2 months (the most relevant time point for
assessing the effect of different treatment sequences). Seven patients experienced serious adverse events (3 ocular and
4 non-ocular events). All but 2 events were judged not related to either treatment; one instance of retinal tear and one of
iritis with reduced visual acuity were judged related to intravitreal bevacizumab administration.
Conclusions: With a goal of collecting data on at least 1000 patients, this registry may raise hypotheses on whether fewer
combination treatments of verteporfin PDT and an anti-VEGF antibody provide a VA benefit comparable to that of monthly
ranibizumab (1-2 line improvement) and whether the sequence of administration affects outcomes. Such hypotheses may
then be tested in randomized clinical trials.