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Jayanth Sridhar, Jason Hsu, Abtin Shahlaee, Sunir Garg, Marc Spirn, Mitchell Fineman, James Vander; Topical dorzolamide-timolol with intravitreal anti-vascular endothelial growth factor for neovascular age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4441.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of topical dorzolamide-timolol on anatomic and functional outcomes in eyes with neovascular age-related macular degeneration (AMD) with persistent exudation despite fixed-interval intravitreal anti-vascular endothelial growth factor (VEGF) injections.
A prospective single-arm interventional study was performed. Patients with neovascular AMD and persistent macular edema despite fixed-interval intravitreal anti-VEGF therapy were enrolled. Baseline spectral-domain optical coherence tomography (SD-OCT) and clinical data including visual acuity (VA) and intraocular pressure (IOP) were obtained at enrollment and from one visit prior to enrollment. Enrolled eyes were placed on topical dorzolamide-timolol twice daily and continued to receive the same intravitreal anti-VEGF therapy at the same interval as received prior to enrollment for the duration of the study. Patients were followed for two visits after enrollment. Central macular thickness (CMT), maximum subretinal fluid (SRF) height, and maximum pigment epithelial detachment (PED) height from SD-OCT were recorded at each visit. Change in CMT was the primary outcome measure. Change in maximum SRF height, maximum PED height, and VA were the secondary outcome measures.
Ten eyes of 10 patients completed the study. 8 eyes received intravitreal aflibercept and 2 eyes received intravitreal ranibizumab. All study eyes had been on chronic anti-VEGF therapy with the same medication prior to study enrollment for an average of 21.9 injections. Mean CMT significantly decreased from 419.7 μm at enrollment to 346.7 μm at the final visit (p=0.029). Mean maximum SRF height decreased from 126.6 μm at enrollment to 62 μm at the final visit (p=0.033) with complete resolution of SRF in 2 of 10 eyes. Mean maximum PED height decreased from 277.4 μm at enrollment to 227.8 μm at the final visit (p=0.13). Mean logarithm of the minimum angle of resolution VA was 0.54 at enrollment and 0.49 at final visit (p=0.62). Mean IOP in the study eyes decreased from 14.5 mm Hg at enrollment to 12.3 mm Hg at final visit (p=0.057).
Topical dorzolamide-timolol significantly reduced macular edema and subretinal fluid in eyes with persistent exudation despite consistent fixed-interval intravitreal anti-VEGF treatment for neovascular AMD.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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