Combined intravitreal bevacizumab and triamcinolone in exudative age-related macular degeneration

Acta Ophthalmol. 2010 Sep;88(6):630-4. doi: 10.1111/j.1755-3768.2008.01502.x.

Abstract

Purpose: We report on the combined application of intravitreal bevacizumab and triamcinolone acetonide for treatment of exudative age-related macular degeneration (AMD).

Methods: The clinical interventional case-series study included 16 patients (16 eyes) with exudative AMD who had previously received 3.5±1.8 mono-injections of bevacizumab (1.5mg) without significant improvement in visual acuity (VA) or reduction in macular exudation. All patients underwent a combined intravitreal injection of bevacizumab (1.5mg) and triamcinolone acetonide (about 20mg). Main outcome measures were VA and macular thickness as determined by optical coherence tomography. All patients were re-examined at 2-3months after the intervention.

Results: Visual acuity improved significantly (p=0.03) from 0.80±0.40 logMAR prior to the combined injection to 0.65±0.42 logMAR at 3 months after the injection. An improvement of ≥1Snellen line was found in eight subjects, an increase of ≥2lines in five subjects, and an improvement of ≥3lines in two subjects. One patient lost 1line and one patient lost 3lines. Central retinal thickness decreased significantly from 272±62μm to 220±47μm (p=0.03). At the 6-month follow-up examination, central retinal thickness had increased again to 319±142μm, which was not significantly (p=0.30) different from baseline measurements.

Conclusions: The combined intravitreal application of bevacizumab and triamcinolone may temporarily be helpful in the treatment of exudative AMD if previous intravitreal bevacizumab mono-injections have failed to improve vision and reduce macular oedema.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Drug Therapy, Combination
  • Exudates and Transudates
  • Female
  • Fluorescein Angiography
  • Glucocorticoids / therapeutic use*
  • Humans
  • Intravitreal Injections
  • Macular Degeneration / drug therapy*
  • Macular Degeneration / physiopathology
  • Male
  • Retina / pathology
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Triamcinolone Acetonide / therapeutic use*
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Glucocorticoids
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Triamcinolone Acetonide