Enlargement of the hypofluorescent post photodynamic therapy treatment spot after a combination of photodynamic therapy with an intravitreal injection of bevacizumab for retinal angiomatous proliferation

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 246; no. 2; pp. 315 - 318
• Main Authors: Rouvas, Alexandros A., Papakostas, Thanos D., Ladas, Ioannis D., Vergados, Ioannis
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.02.2008; Springer Nature B.V
• Subjects: Aged; Angiogenesis Inhibitors - administration & dosage; Angiogenesis Inhibitors - adverse effects; Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal - adverse effects; Antibodies, Monoclonal, Humanized; Bevacizumab; Case Report; Coloring Agents; Combined Modality Therapy; Female; Fluorescein Angiography; Fluorescence; Humans; Indocyanine Green; Injections; Macular Degeneration - complications; Macular Degeneration - drug therapy; Medicine; Medicine & Public Health; Ophthalmology; Photochemotherapy - adverse effects; Photosensitizing Agents - adverse effects; Photosensitizing Agents - therapeutic use; Porphyrins - adverse effects; Porphyrins - therapeutic use; Retina - drug effects; Retinal Neovascularization - drug therapy; Retinal Neovascularization - etiology; Retinal Neovascularization - pathology; Tomography, Optical Coherence; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity; Vitreous Body; Hypofluorescence; Photodynamic therapy; Age-related macular degeneration; Retinal angiomatous proliferation; Bevacizumab
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-007-0669-3

Background To report a case of enlargement of the post photodynamic therapy treatment (PDT) spot in a patient with retinal angiomatous proliferation (RAP) that was treated with PDT combined with an intravitreal injection of bevacizumab. Methods 74-year-old woman with RAP due to age-related macular degeneration was treated with one verteporfin PDT session, sequenced by a single intravitreal injection of bevacizumab (1.25 mg) after 30 minutes. Results The patient’s visual acuity (VA) at baseline was 20/200 and is now at the 10-month follow-up visit 20/400, while the RAP has disappeared according to the indocyanine angiography (ICG) findings. The post PDT hypofluorescent treatment spot has enlarged from 1,450 μm at the day of the treatment, to 5,360 μm at the 6-week visit. The patient is now at the 10-month follow-up visit and the hypofluorescence is still persisting. Conclusion The simultaneous combination of PDT with bevacizumab in patients with RAP may enhance the photochemical stress in normal choroid with prolonged and magnified hypofluorescence in ICG, due to ischemia in normal choriocapillaries.