Visual acuity improvement was defined as a gain of at least 3 ETDRS lines (15 letters), stability as a change of less than 3 ETDRS lines, and deterioration as a loss of at least 3 ETDRS lines. Central macular thickness (CMT) examinations were performed selleck products using a STRATUS OCT (V4.01 Zeiss Meditec, Dublin, CA). CMT was assessed using the high-resolution Radial Lines protocol and the Retinal Thickness Map analysis program. AMD neovascular lesions were defined by intraretinal hemorrhages and edema. From the baseline thickness, a decrease in CMT of ��10% was defined as a reduction and an increase ��10% was defined as an increase. Fluorescein angiography was performed by three trained unmasked photographers using a HRA2 FA (Heidelberg Engineering).

The presence of CNV leakage was evaluated in the late (3�C5 min) versus the early (first 1�C2 min) phase. The leakage was compared between the times before and after treatment and was described as absent (CNV closure) or persistent. A relapse was defined as an evidence of leakage on fluorescein angiography and/or evidence of intraretinal or subretinal fluid on OCT from a previously closed lesion. OCT imaging procedures and fluorescein angiographies were evaluated by three experienced (unmasked) retinal specialists at baseline and during the follow-up, every month for 6 months. Intraocular pressure (IOP), measured by applanation tonometry, was monitored. Diastolic and systolic blood pressures were recorded at baseline and during follow-up. At baseline, the combined therapy group was treated with PDT-V and intravitreal ranibizumab administered on the same day.

Monthly, additional ranibizumab injections were administered at month 1 and 2 in case of persistent activity of the neovascular lesion. Group 2 was treated with three monthly injections. Eyes underwent standard PDT-V (Visudyne; Novartis AG, Basel, Switzerland) with the following protocol: a 10-minute infusion of verterporfin (6 mg/m2 body surface area) was followed by its activation (5 minutes later) with a 689-nm diode laser delivering an energy of 50 J/cm2 for 83 seconds, using a spot size of a diameter 1000 ��m larger than the greatest linear dimension of the lesion. Each patient was asked to wear protective sunglasses and to avoid exposure of the eyes and body surfaces to sunlight for the next 48 hours. They were given an intravitreal injection of 0.

5 mg of ranibizumab on the same day. Before the injection, tetracaine 1% eye drops were instilled and povidone-iodine was applied to the eyelid margins and the lashes. After the application of a sterile drape, a lid speculum was inserted and povidone-iodine 5% ophthalmic solution applied to the eye, which was flushed after 90 seconds with saline solution. GSK-3 A volume of 0.5 mg (0.05 ml) of ranibizumab was injected through a 30-gauge needle.