Terapia anti-VEGF versus Fototerapia dinámica en pacientes con degeneración macular húmeda relacionada a la edad. Revisión sistemática

Abstract

Age-related wet macular degeneration (AMD) is a leading cause of blindness in older adults. This study compares the efficacy and safety of anti-vascular endothelial growth factor (anti-VEGF) therapies and photodynamic therapy (PDT), both individually and in combination, assessing their impact on visual acuity, disease progression, and patient quality of life. Methodology: A systematic review of recent studies on anti-VEGF and PDT therapies in patients with wet AMD was conducted, focusing on controlled trials that assessed improvements in visual acuity and reductions in central macular thickness (CMT). Data were analyzed using Forest Plots and random-effects models to compare the treatment efficacy. Results: The findings indicate that monotherapy with anti-VEGF treatments effectively reduces CMT and improves visual acuity, significantly outperforming PDT. However, combined therapies (anti-VEGF + PDT) were proven particularly beneficial for patients with advanced or refractory AMD, achieving greater visual stability and reducing the frequency of required injections. The combination of PDT with anti-VEGF did not significantly increase the incidence of adverse events. Conclusions: Anti-VEGF therapies are the most effective in improving vision and reducing retinal thickness, highlighting their combined efficacy with PDT in advanced or resistant cases. Individualized treatment is essential to optimize outcomes and improve the quality of life for these patients. Keywords: wet age-related macular degeneration, anti-VEGF therapies, photodynamic therapy, visual acuity, bevacizumab