Abstract:AIM: To observe the efficacy of ω-3 polyunsaturated fatty acids in patients with age-related macular degeneration(ARMD)after receiving a poor response to the combination of ranibizumab and photodynamic therapy(PDT).
METHODS: Ninety-two cases(122 eyes)of patients with age-related macular degeneration in our hospital from February 2015 to January 2017 were selected as the subjects. All patients were given intravitreal ranibizumab injection combined with photodynamic therapy, according to the received light sensitive dose were randomly divided into half dose group(45 eyes of 60 cases)and full dose group(47 eyes of 62 cases), half dose group received half dose verteporfin(3mg/m2), the full dose group received full dose verteporfin(6mg/m2). The patients were followed up for 1mo, 3mo after treatment. After 3mo treatment, 41 eyes of 30 patients paitents who got choroidal neovascularization(CNV)leakage again or leakage increased were randomly divided into control group of 14 cases(20 eyes), experimental group of 16 cases(21 eyes). All patients were treated with ranibizumab combined with half dose verteporfin(3mg/m2), photodynamic therapy. The experimental group were added with ω-3 polyunsaturated fatty acids soft capsule(twice per day, 1 tablets per time, period of 6mo). All patients were followed up at 1, 3 and 6mo after treatment.best corrected visual acuity(BCVA), central macular retinal thick(CRT), intraocular pressure, total effective rate of CNV, the average number of injections of ranibizumab and adverse reactions were observed during the follwed up.
RESULTS: The BCVA, CRT, intraocular pressure before and after 1,3mo treatment and the total efficiency of CNV of half dose group were no statistical differences with the full dose group(P>0.05). The number of times ranibizumab injection of half dose group(1.1±0.8, 1.6±1.2)were lower than that in the full dose group(1.6±1.1, 2.5±1.7)at 1 and 3mo after treatment, the differences were statistically significant(P<0.05). The BCVA and CNV in experimental group was higher, CRT and ranibizumab injection times were lower than that in the control group at 1,3 and 6mo after treatment, the differences were statistically significant(P<0.05). No serious adverse reactions related treatment were occurred in all patients.
CONCLUSION: It is safe and effective to treat patients with age-related macular degeneration by ranibizumab combined with half dose photodynamic therapy. The combination of ω-3 polyunsaturated fatty acids can improve the therapeutic effect.