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M. J. Tolentino, A. Berger, D. Misch, S. Moon, R. Hamilton, M. J. Espiritu; Decreased Retreatments and Maintained Efficacy With Triple Therapy (Combination Verteporfrin Photodynamic Therapy, Intravitreal Avastin/Lucentis and Intravitreal Dexamethasone Treatments) for Patients With Exudative Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2008;49(13):542.
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To determine if triple therapy (combining intravitreal Avastin/Lucentis with PDT and intravitreal dexamethasone) can reduce the number of retreatments while maintaining improvement in vision in patients with exudative age related macular degeneration.
: Previously treated or patients naïve to treatment with exudative age related macular degeneration treated with triple therapy (intravitreal injections of Avastin (1.25 mg)or Lucentis (0.5 mg), Verteporfrin photodynamic therapy and intravitreal injections of dexamethasone (800 ug)) were identified from the computerized records of one retina only private practices. The three therapies had to be performed within 2 weeks of each other. Reduced fluence (25J/M2) or standard fluence (50J/MM) PDT was allowed. Only patients with at least 3 month follow up were analyzed. Change in snellen visual acuity was the primary endpoint and the rate of retreatments was the secondary endpoints.
78 eyes from 75 patients had at least 3 month follow-up and 57 eyes of 54 patients had at least 6 month follow-up. Patients with 3 month follow-up showed 16/78(21%) eyes gained more than 3 lines of vision, 69/78 (88%) eyes did not lose any lines of vision and 75/78 (96%) of eyes did not lose more than 3 lines of vision. Within the 3 month follow-up 56/78 (72%) did not need retreatment. Patients with 6 month follow-up showed 12/57 (21%) eyes gained more than 3 lines of vision, 49/57 (86%) eyes did not lose any lines of vision and 55/57(96%) of eyes did not lose more than 3 lines of vision. Within the 6 month follow-up only 34/57 (61%) did not need retreatment.
Triple therapy appears to provide excellent efficacy and decreases the rate of retreatment.
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