Triple therapy effective after just one treatment cycle in AMD

For most patients with choroidal neovascularization (CNV) resulting from age-related macular degeneration (AMD), triple therapy offers significant and sustained visual improvement after just one cycle of treatment, according to a paper published in the February issue of Retina.

Albert Augustin, MD and colleagues from the Klinikum Karlsruhe, Karlsruhe, Germany, conducted a prospective, non-comparative, interventional case series including 104 subjects with CNV. Veterporfin photodynamic therapy (PDT) was administered first with a reduced light dose (42 J/cm). Approximately 16 hours later, dexamethasone (800 µg) and bevacizumab (1.5 mg) were injected intravitreally. Patients were followed up very six weeks, undergoing visual acuity (VA) and intraocular pressure (IOP) measurements, slit-lamp and ophthalmoscopic examinations and optical coherence tomography (OCT). Fluorescein angiography was performed at three-month intervals.

Each subject received one cycle of triple therapy and five received a second cycle because of remaining CNV activity. Eighteen patients received an additional intravitreal injection of bevacizumab. The mean follow-up period was 40 weeks.

Follow-up examinations revealed a mean increase in VA of 1.8 lines (p<0.01) and a mean decrease in retinal thickness of 182 µm (p<0.01). No serious adverse events were observed.

The authors concluded that triple therapy for CNV resulting from AMD, can result in significant and sustained improvement in VA. In addition, the therapy is well tolerated and offers greater convenience for patients.