Intravitreal bevacizumab vs verteporfin photodynamic therapy for Neovascular age-related macular degeneration

Objective: To compare verteporfin photodynamic therapy (PDT) with intravitreal bevacizumab for management of choroidal neovascularization (CNV) associated with age- related macular degeneration. Methods: Patients with predominantly classic CNV were prospectively randomized to receive standard PDT or intravitreal bevacizumab injections (2.5 mg). Best-corrected visual acuity (BCVA) measured by Snellen charts, central retinal thickness by optical coherence tomography, and greatest linear dimension of the CNV by fluorescein angiography were compared between the groups at baseline and at 3 and 6 months. Main outcome measures were stability or improvement in BCVA, decrease in central retinal thickness, and stability in greatest linear dimension. Results: Mean baseline BCVA, central retinal thickness, and greatest linear dimension were not statistically different between the bevacizumab (n= 32) and PDT (n= 30) groups. Mean central retinal thickness was significantly better at 3 and 6 months in the bevacizumab group vs the PDT group (P=. 04 and P=. 002, respectively). At 3 months, mean BCVA and greatest linear dimension were not significantly different between the 2 groups. At 6 months, mean BCVA and greatest linear dimension were significantly better in the bevacizumab group (P <. 001 and P=. 02, respectively). Conclusion: During 6 months, intravitreal bevacizumab was superior to PDT in controlling predominantly classic CNV in age- related macular degeneration. Additional randomized clinical trials are necessary to determine if this benefit will remain with longer follow- up.