Intravitreal bevacizumab versus combined bevacizumab and triamcinolone acetonide for neovascular age-related macular degeneration
Journal of Ophthalmic and Vision Research. 2008; 3 (2): 95-101
em Inglês
| IMEMR
| ID: emr-143556
ABSTRACT
To compare the short-term outcomes of intravitreal bevacizumab [IVB] with the combination of IVB and intravitreal triamcinolone acetonide [IVB/IVT] for treatment of neovascular age-related macular degeneration [AMD]. This randomized clinical trial was performed on 92 eyes of 90 patients with subfoveal and juxtafoveal choroidal neovascularization [CNV] secondary to AMD. The eyes were randomly assigned to receive IVB 1.25 mg alone [53 eyes] or in combination with IVT 2 mg [39 eyes]. Best-corrected visual acuity [BCVA] and fundus autofluorescence were assessed, and fluorescein angiography [FA] and optical coherence tomography [OCT] were performed at baseline and repeated 6 weeks after treatment. Mean age was 70.6 +/- 8.7 [range 50-89] years and 57.7% of the patients were male. BCVA improved from 1.03 +/- 0.40 to 0.93 +/- 0.38 logMAR [P=0.001] in the IVB group and from 1.08 +/- 0.33 to 0.91 +/- 0.38 logMAR [P=0.008] in the IVB/IVT group. There was a trend toward greater visual improvement with combined therapy [P=0.06]. BCVA improvement was greater in eyes with +1 versus those with +2 [P=0.049] and +3 [P < 0.001] fundus autofluorescence at baseline. Mean decrease in central macular thickness was 113 +/- 115 micro m [P < 0.001] in the IVB group versus 53.96 +/- 125 micro m [P=0.008] in the IVB/IVT group with no intergroup difference [P=0.38]. FA showed decreased leakage in 57.4%, increased leakage in 12.8% and no change in 29.8% of patients in the IVB group. Corresponding figures were 60.0%, 5.7% and 34.3% in the IVB/IVT group [P=0.556]. Addition of triamcinolone acetonide to bevacizumab for treatment of neovascular AMD does not seem to significantly increase its short-term efficacy. More severe fundus autofluorescence appears to be predictive of poorer response to treatment
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Índice:
IMEMR (Mediterrâneo Oriental)
Assunto principal:
Idoso
/
Triancinolona
/
Acuidade Visual
/
Estudos Prospectivos
/
Resultado do Tratamento
/
Inibidores da Angiogênese
/
Fator A de Crescimento do Endotélio Vascular
/
Tomografia de Coerência Óptica
/
Quimioterapia Combinada
/
Anticorpos Monoclonais
Tipo de estudo:
Ensaio Clínico Controlado
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
J. Ophthalmic Vision Res.
Ano de publicação:
2008
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