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Andrea Russo, Elena Gambicorti, Francesco Morescalchi, Francesco Semeraro; Prospective Randomized Controlled Trial of Combination Ranibizumab and Indomethacin for Neovascular Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):803.
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To evaluate whether indomethacin eyedrops and ranibizumab intravitreal (IVR) injections would provide additional benefit over ranibizumab alone in the treatment of choroidal neovascularization (CNV).
This was a randomized, prospective pilot study of eyes with new-onset CNV. Fifty-eight patients were randomized 1:1 into a ranibizumab monotherapy (RM) group and a ranibizumab plus indomethacin (RI) group. All patients received monthly 0.5 mg IVR injections for 3 months, followed by monthly injections administered as needed. RI group patients also self-administered one drop of 0.5% indomethacin three times a day for 12 months. All patients were followed up for 12 months.
At 12 months, both groups showed significant improvement in BCVA and CRT. The mean BCVA change from baseline to 12 months was -0.12 ± 0.04 LogMAR and -0.20 ± 0.04 LogMAR in the RM and RI groups, respectively. At 12 months, the mean CRT (±SE) was -316 ± 41.2 µm and -287 ± 31.5 µm in the RM and RI groups, respectively. The mean required number of IVR injections was 7.38 ± 0.78 and 6.34 ± 0.67 in the RM and RI groups, respectively (P < 0.001).
Compared to IVR monotherapy, combination therapy with indomethacin eyedrops and IVR provides superior anatomical and visual outcomes in patients with naïve CNV lesions. Moreover, topical indomethacin might reduce the frequency of IVR injections, which is very beneficial considering the chronic and expensive nature of IVR therapy.
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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