July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Examination of the effect of topical aqueous suppressants on the efficacy of anti-VEGF infections for age-related macular degeneration
Author Affiliations & Notes
  • Jonathan Minkowski
    Ophthalmology , Rush University Medical Center, Chicago, Illinois, United States
  • Mathew MacCumber
    Ophthalmology , Rush University Medical Center, Chicago, Illinois, United States
    Illinois Retina Associates, S.C., Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Jonathan Minkowski, None; Mathew MacCumber, Genentech (C), Regeneron (C)
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 832. doi:
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      Jonathan Minkowski, Mathew MacCumber; Examination of the effect of topical aqueous suppressants on the efficacy of anti-VEGF infections for age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):832.

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

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Abstract

Purpose : A retrospective pilot study to examine whether topical aqueous suppressants may augment the efficacy of anti-VEGF injections in eyes with age-related macular degeneration (AMD).

Methods : Patients of Illinois Retina Associates from 2012 thru 2014 were initiated on topical aqueous suppressants, timolol and/or dorzolamide, when they were showing evidence of incomplete response to anti-VEGF injections for AMD. Patients included had a minimum of six months of continuous treatment on a topical aqueous suppressant. Snellen visual acuities were converted to log MAR acuity for analysis. Central subfield thickness (CST) was measured by spectral domain OCT.

Results : There were 13 eyes of 13 patients who met the inclusion criteria. 10 eyes received topical beta-blocker (timolol) combined with CAI (dorzolamide); 2 eyes received topical beta-blocker (timolol) and one eye received CAI (dorzolamide) only. From the pre-baseline visit through the six month follow up visit, all eyes were maintained on the same anti-VEGF injection (12 afibercept and 1 ranibizumab). Mean baseline visual acuity was 20/53 and mean six month visual acuity was 20/55. The mean baseline CST was 319 (median: 280, range: 233-586) and the mean six month visit CST was 249 (median: 255, range 185-340). 11 out of 13 eyes showed a decrease in the CST measurement between baseline and the six month follow up. The 13 eyes received a mean number of 3.8 anti-VEGF injections over the course of the six month follow up period (not including baseline visit).

Conclusions : Topical aqueous suppressants may be a useful adjunct in the management of patients with AMD undergoing routine anti-VEGF injections. Another series of patients with AMD has been reported who demonstrate similar benefit in CST with this approach (Sridhar, et al. JAMA Ophthalmol. 2016;134:437-443) Use of aqueous suppressants may decrease overall intra-ocular fluid turnover or have direct effects on retinal function thereby potentiating anti-VEGF effect. Larger controlled studies are warranted to confirm these effects.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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