The blood and serous fluid causes alterations in the macula, distorting images and causing loss of visual acuity. Although the natural course of CNV secondary to AMD is highly variable, the long-term prognosis is Ruxolitinib buy poor.3 Several therapeutic options are available. In 2000 photodynamic therapy with verteporfin (PDT-V) was approved by the United States�� Food and Drug Administration for the treatment of subfoveal CNV due to AMD.4 Recently, clinical investigations have studied a new class of drugs for subfoveal CNV: vascular endothelial growth factor (VEGF) selective inhibitors, administered via intravitreal injection.5,6 More recently, clinicians have been offering a combined treatment, consisting of PDT followed by an intravitreal injection of an anti-VEGF drug within 24 hours.

The combination of two treatments should have better results in preventing the growth of new vessels.7�C10 The purpose of our study is to compare combined therapy of PDT-V and intravitreal ranibizumab versus monotherapy with ranibizumab. Subjects and Methods This study was conducted in compliance with the Ethics Committee of the Department of Ophthalmology of the University of Rome ��La Sapienza�� and in accordance with all state laws in Italy. Prior to determination of full eligibility for enrollment, all patients provided written, informed consent. Our open-label, single-center, randomized controlled trial was designed to compare the efficacy of combined therapy, defined as intravitreal ranibizumab 0.5 mg and PDT administered on the same day, versus a group treated with ranibizumab-alone in eyes with primary classic CNV secondary to AMD.

Inclusion criteria were a best-corrected visual acuity (BCVA) letter score equal or better than 10 letters (Snellen equivalent 20/200), classic subfoveal CNV lesions due to AMD, greatest linear dimension (GLD) of the entire lesion ��5400 ��m, at least 55 years of age, and active CNV secondary to AMD with evidence of leakage on fluorescein angiography (FA). Exclusion criteria were previous treatment with bevacizumab or pegaptanib. Patients previously treated with PDT were excluded. Patients were also excluded if they had uncontrolled diabetes, a history of coagulation disorders, cerebrovascular accidents, pulmonary embolism, deep vein thrombosis, uncontrolled systemic hypertension, chronic renal failure, myocardial infarction within the previous 6 months, major surgery within the previous 6 weeks, ocular diseases that could affect visual acuity (eg, glaucoma, angioid streaks, trauma, choroiditis, hereditary diseases [even to fellow untreated eyes], aphakia), or previous vitreoretinal surgery.

Patients were randomized into two groups with a 1:2 ratio: group 1 patients received the combined therapy; group 2 patients, monotherapy with ranibizumab. All patients underwent full ophthalmologic examination at baseline and during the follow-up Carfilzomib period.