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S. A. Zweifel, S. Khan, M. Engelbert, K. B. Freund; Efficacy of Topical Bromfenac (0.09%) as an Adjunctive Therapy for Patients With Neovascular Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5006.
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To assess the efficacy of topical bromfenac (0.09%) as an adjunctive therapy for patients with neovascular age-related macular degeneration (AMD) demonstrating persistent exudation despite monthly intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy.
Twenty-one consecutive patients (22 eyes) who manifested persistent subretinal and/or intraretinal fluid after at least three monthly intravitreal injections of ranibizumab or bevacizumab were prescribed topical bromfenac (0.09%) ophthalmic solution twice daily for two months. The efficacy of topical bromfenac was evaluated by comparing visual acuity (log MAR and Snellen equivalent) and masked readings of spectral domain optical coherence tomography (OCT) center-point retinal thickness, height of pigment epithelial detachment (when present), and central 6mm² (128x512 A-scan) volume measurements at baseline and at one and two months following the initiation of combined treatment.
The mean visual acuity logMAR (Snellen equivalent) at baseline was 0.51±0.35 (20/95) and did not change significantly after 1 month 0.53±0.35 (p=0.68, paired student t-test) or 2 months 0.52±0.34 (p=0.75) following the initiation of combined treatment. The mean central retinal thickness was 311µm at baseline, 308µm (p=0.73, paired student t-test) after one month, and 299µm (p=0.34) after two months. The comparison of the macular volume did not show any statistically significant change. In 20 eyes of 19 patients manifesting a PED, the mean PED height was 275µm at baseline, 271µm (p=0.33, paired student t-test) at one month, and 274µm (p= 0.76) at two months. There were no adverse events associated with the extended topical administration of topical bromfenac.
In patients with neovascular AMD manifesting persistent exudation despite monthly intravitreal anti-VEGF therapy, we could not detect a beneficial effect of adding topical bromfenac (0.09%) over two months.
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