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

Abstract

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

Methods: : Clinical interventional case-series includes 14 patients (14 eyes) with exudative age-related macular degeneration who had previously received 3.7 ± 1.9 mono-injections of bevacizumab (1.5 mg) without improvement of visual acuity or reduction of 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=0.008) from 0.81±0.43 logMAR prior to the combined injection to 0.67±0.41 log MAR. An improvement of at least 1 Snellen line was found in 10 (71%) patients, an increase of at least 2 lines in 5 (36%) patients, and an improvement of 3 or more lines in 1 (7%) patient. One patient (7%) lost 1 line. The central retinal thickness decreased significantly from 255 ± 59 µm to 224 ± 45 µm (P=0.03).

Conclusions: : The combined intravitreal application of bevacizumab and triamcinolone might be favourable in the treatment of exudative age-related macular degeneration, if preceding intravitreal bevacizumab mono-injections failed to improve visual acuity and reduce macular edema.

Keywords: age-related macular degeneration • visual acuity • injection