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Triple combination therapy may improve VA in treatment of wet AMD
Retina. 2011;31(3):446-452.
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A triple combination therapy for wet age-related macular degeneration may improve visual acuity and reduce retinal thickness, a study found.
The retrospective, consecutive case series assessed 31 eyes treated with Avastin (bevacizumab, Genentech), low-fluence photodynamic therapy and posterior sub-Tenon's triamcinolone.
A statistically significant improvement in visual acuity of 0.140 ± 0.273 logMAR occurred at 3 months postop (P = .0219). At 6 months, visual acuity had improved by 0.182 ± 0.383 logMAR (P = .047). However, while 73.1% of eyes showed no vision loss or an improvement at the conclusion of follow-up, there were no statistically significant visual improvement at 12 months.
The majority of vision loss occurred between 6 and 12 months postop. The efficacy of bevacizumab therapy may be transient or the variance in follow-up duration and frequency may have affected results, the study authors said.
However, the difference in visual acuity at final follow-up between those who required re-treatment (approximately 50%) and those who did not supports the potential of triple combination therapy, according to the authors.
Central retinal thickness improved significantly at 3 months, 6 months and 12 months, with an improvement of -101.6 ± 103.3 µm at 12 months. Three patients experienced an increase in IOP.
Prospective studies should be conducted to determine the duration of action for anti-VEGFs in monotherapy and combination therapy, the study authors said.