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A. J. Augustin, I. Offermann; Triple Therapy for the Treatment of Wet AMD. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1167.
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To evaluate the efficacy and safety of triple therapy with verteporfin photodynamic therapy (PDT), dexamethasone, and bevacizumab in CNV secondary to AMD.
This prospective, noncomparative, interventional case series included 104 patients. PDT was administered with a reduced light dose (42 J/cm2, accomplished by light delivery time of 70 seconds). About 16 hours after PDT, dexamethasone (800 µg) and bevacizumab (1.5 mg) were applied intravitreally. Patients attended follow-up visits every 6 weeks, undergoing VA and intraocular pressure measurement, slit-lamp and ophthalmoscopic examination, and optical coherence tomography. Fluorescein angiography was performed every 3 months or earlier if OCT showed significant edema.
All 104 patients received one triple therapy cycle (5 patients received a second triple treatment due to remaining CNV activity). The triple therapy was complemented in 23 patients (22.1%) by an additional intravitreal injection of bevacizumab. The mean follow-up period is currently at 62 weeks. Mean increase in visual acuity was 1.78 lines (P<0.01). Mean decrease in retinal thickness was 171 µm (P<0.01). No serious adverse events have been observed.
In most of the patients with CNV due to AMD, triple therapy results in significant and sustained visual acuity improvement after only one cycle of treatment. In addition, the therapy offers a good safety profile, potentially lower cost and convenience for patients.
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