April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Combination Therapy for Choroidal Neovascularization Due to Age-Related Macular Degeneration Unresponsive to Anti-VEGF Monotherapy. Intravitreal Bevacizumab and Triamcinolone Acetonide
Author Affiliations & Notes
  • D. Veritti
    Department of Ophthalmology, University of Udine, Udine, Italy
  • V. Sarao
    Department of Ophthalmology, University of Udine, Udine, Italy
  • C. Savorgnani
    Department of Ophthalmology, University of Udine, Udine, Italy
  • G. Polini
    Department of Ophthalmology, University of Udine, Udine, Italy
  • P. Lanzetta
    Department of Ophthalmology, University of Udine, Udine, Italy
  • Footnotes
    Commercial Relationships  D. Veritti, None; V. Sarao, None; C. Savorgnani, None; G. Polini, None; P. Lanzetta, Neovista Inc, C; Novartis Pharma AG, C; Iridex Co, P; Allergan, R; Novartis Pharma AG, R; QLT Inc, R; Optimedica Co, R.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 104. doi:
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      D. Veritti, V. Sarao, C. Savorgnani, G. Polini, P. Lanzetta; Combination Therapy for Choroidal Neovascularization Due to Age-Related Macular Degeneration Unresponsive to Anti-VEGF Monotherapy. Intravitreal Bevacizumab and Triamcinolone Acetonide. Invest. Ophthalmol. Vis. Sci. 2010;51(13):104.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate the safety and exploratory efficacy of combination therapy with intravitreal bevacizumab and intravitreal triamcinolone acetonide in choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) unresponsive to anti-VEGF monotherapy.

Methods: : Ten sequential eyes with CNV due to AMD were included in this retrospective chart review. They received a single session combination of intravitreal bevacizumab (1 mg/ 0.04 ml) and triamcinolone acetonide (4 mg/ 0.1 ml). Indication for treatment was a failed response to anti-VEGF monotherapies, defined as persistent or recurrent subretinal and/or intraretinal fluid on optical coherence tomography (OCT). Patients received monthly follow-up examinations after treatment. Best corrected visual acuity (BCVA), fluorescein angiography (FA), indocyanine green angiography (ICGA) and OCT were performed at every follow-up visit.

Results: : Mean follow-up is 4.8 months. Each patient received a mean of 6 intravitreal anti-VEGF agent injections before enrollment. Mean BCVA (±SD) was 1.27 (±0.5) logMAR and 1.06 (±0.5) logMAR at baseline and at the end of follow-up respectively. Mean central retinal thickness (±SD) was 441.8 (±44.1) µm at baseline and 316.4 (±130.3) µm at the end of follow-up [p=0.014]. Two patients experienced reactivation of CNV lesion within the follow-up period and required an additional combined treatment or a anti-VEGF injection alone. Five eyes (50%) showed no sign of any fluid at the end of the follow-up. Two eyes (20%) required topical treatment due to significant intraocular pressure increase.

Conclusions: : The combination of intravitreal bevacizumab and triamcinolone acetonide is a safe treatment option for CNV due to AMD and can potentially offer a new treatment modality for neovascular lesions not responding to anti-VEGF monotherapy. Further studies are needed to evaluate functional results.

Keywords: age-related macular degeneration • choroid: neovascularization • retina 
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