First Author: G.Bellizzi ITALY
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Long term effectiveness valuation of micropulse laser therapy after multiple anti-VEGF treatment in non-responder patient with wet AMD and juxtafoveal polypoid CNV.
Studio Oculistico Bellizzi, Bari (Italy)
Old male patient with wet AMD in right eye and early dry AMD in left eye confirmed by ICG angiography,treated every 2 month with intravitreal aflibercept for 1 year and after with ranimizumab monthly in right eye for 6 month. The response was poor, even if the central visual acuity was stable on 0,1 LogMAR. OCT showed persistent subretinal fluid and thickening of RPE for all the duration of the treatment as constant activity of CNV. 2 weeks after the last IVT injection was proposed a subthreshold micropulse laser therapy. The single treatment was performed with 577nm yellow laser.
1 month after treatment the macular thickness was reduced with sensible gain in central visual acuity; 2 years later, the CNV was completely inactive and resolved without presence of edema, macular thickness normalized and BCVA improved without progression of the AMD.
Probably micropulse laser therapy does not eliminate the need of anti-VEGF treatment but converts non-responders to responders and enables longer treatment-free intervals wich reduces costs for healthcare and systemic side effects of IVT.