Combined Intravitreal Bevacizumab and Triamcinolone for Exudative Age-Related Macular Degeneration

Abstract

Purpose: : To report on the combined application of intravitreal bevacizumab with triamcinolone acetonide for treatment of exudative age-related macular degeneration.

Methods: : The clinical interventional case-series study included 16 patients (16 eyes) with exudative age-related macular degeneration who had previously received 3.5 ± 1.8 mono-injections of bevacizumab (1.5 mg) without significant improvement in visual acuity or reduction in macular exudation. All patients underwent a combined intravitreal injection of bevacizumab (1.5 mg) and triamcinolone acetonide (about 20 mg). Main outcome measures were visual acuity and macular thickness as determined by optical coherence tomography. All patients were re-examined at 2 to 3 months after the intervention.

Results: : Visual acuity improved significantly (P=0.03) from 0.80 ± 0.40 logMAR prior to the combined injection to 0.65 ± 0.42 log MAR at 3 months after the injection. An improvement by at least one Snellen line was found for 8 subjects, an increase by at least 2 lines for 5 subjects, and an improvement of 3 or more lines for 2 subjects. One patient lost one line, and one patient lost 3 lines. The central retinal thickness decreased significantly from 272 ± 62 µm to 220 ± 47 µm (P=0.03). At the 6 months follow-up examination, the central retinal thickness increased again to 319 ± 142 µm, which was not significantly (P=0.30) different from the baseline measurements.

Conclusions: : The combined intravitreal application of bevacizumab and triamcinolone may temporarily be helpful in the treatment of exudative age-related macular degeneration if previous intravitreal bevacizumab mono-injections failed to improve vision and reduce macular edema.

Keywords: age-related macular degeneration • drug toxicity/drug effects • choroid: neovascularization