The purpose of this study is to investigate the efficacy and safety of intravitreal dexamethasone sodium phosphate (DSP) combined with bevacizumab for the treatment of neovascular age-related macular degeneration (AMD). In this non comparative case study, 30 eyes of 27 patients with CNV due to AMD received intravitreal DSP (0.2 mg) and bevacizumab (1.25 mg) during a 6-month PRN (pro re nata) dosing regimen. Visual acuity, macular thickness and intraocular pressure (IOP) were monitored and recorded. After 6 months, mean retinal thickness decreased from 423.5 ± 75.3 to 228.2 ± 34.5 and mean visual acuity improved from 0.9 ± 0.39 logMAR to 0.53 ± 0.34 (p = 0.001) logMAR. During the trial period, 81 intravitreal injections were performed in 30 eyes, thus the mean number of injections per eye was 2.7 ± 1.1. 86.7% of the eyes required 3 or less injections while only 13.3% needed 4 or more injections. None of the patients, phakic or pseudophakic, manifested an elevation of IOP during the treatment, ranging between 12 and 22 mmHg. Combined DSP and bevacizumab offers encouraging results in the challenge of AMD treatment, providing immediate response of macular edema, reduced number of intravitreal injections and stabilization or improvement of visual acuity.
Purpose: To identify the differences between combination bevacizumab plus dexamethasone and ranibizumab in treatment naïve neovascular age-related macular degeneration in terms of functional/morphological outcomes and number of injections when evaluated in real-life clinical practice.
Methods:We compared two groups of patients either receiving intravitreal bevacizumab (1.25 mg) plus dexamethasone sodium phosphate (0.2 mg) or intravitreal ranibizumab (0.5 mg) over a 12 month period. The former, Group A, received treatment at baseline and followed a pro re nata (PRN) regimen. The latter, Group B, received treatment at baseline followed by two additional monthly injections as per the universally accepted protocol whilst continuing treatment on PRN regimen thereafter. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit-lamp fundus examination and central macular thickness (CMT) via optical coherence tomography (OCT) were recorded at the initial visit (Baseline, BSL) and at each subsequent follow-up visit.Results: CMT at BSL was 362.8 ± 45.4 μm in Group A and 358.3 ± 47.2 μm in Group B. At the end of the data analysis, CMT was improved substantially in both groups (246.1 ± 42.4 μm in Group A, 254.9 ± 21.2 μm in Group B), while BCVA improved as well (From 0.87 ± 0.15 logMAR to 0.48 ± 0.15 in Group A, from 0.81 ± 0.20 logMAR to 0.52 ± 0.10 in Group B). Group A received 248 injections, whereas Group B received 313.
Conclusion:Combination treatment with DSP and bevacizumab provided the same efficacy and allowed a statistically significant reduction in the frequency of injections compared with ranibizumab monotherapy.
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