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Intravitreal bevacizumab versus combined intravitreal bevacizumab and triamcinolone for neovascular age-related macular degeneration: six-month results of a randomized clinical trial.
Retina 2011; 31(9):1819-26R

Abstract

PURPOSE

To determine whether combined intravitreal bevacizumab (IVB) and triamcinolone (IVT) is more effective than IVB alone in neovascular age-related macular degeneration.

METHODS

This was a prospective, randomized clinical trial performed at two centers. Eligible eyes were assigned randomly to one of the two study arms. In the IVB group, 3 consecutive injections of 1.25 mg of bevacizumab were given 6 weeks apart, while in the IVB/IVT group, the first of the triple IVB injections was combined with 2 mg of IVB. A fourth IVB was injected in eyes demonstrating active choroidal neovascularization at Week 24.

RESULTS

Sixty and 55 eyes were in the IVB and IVB/IVT groups, respectively. Best-corrected visual acuity improved, and central macular thickness was reduced significantly in both groups at all time points. Visual improvement was more pronounced in the IVB/IVT group compared with the IVB group 6 weeks (8.5 ± 14.4 vs. 3.8 ± 8.9 letters, P = 0.04) and 12 weeks (11.8 ± 16.6 vs. 6.2 ± 10.8 letters, P = 0.03) after initiation of therapy. However, there was no significant difference in visual improvement at Week 24 (11.3 ± 17.2 letters in the IVB/IVT group vs. 8.7 ± 15.6 letters in the IVB group, P = 0.40). The IVB/IVT group showed significantly less need for a fourth injection at Week 24 (34.5% vs. 53.3% in the IVB/IVT and IVB groups, respectively, P = 0.04).

CONCLUSION

Mandated therapy with IVB improved best-corrected visual acuity and decreased central macular thickness in neovascular age-related macular degeneration. The addition of low-dose IVT temporarily increased the therapeutic efficacy in the early postinjection period and resulted in fewer requirements for repeat IVB injections at 6 months; however, final levels of visual improvement were comparable in the 2 study groups.

Authors+Show Affiliations

Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. hahmadieh@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

21555967

Citation

Ahmadieh, Hamid, et al. "Intravitreal Bevacizumab Versus Combined Intravitreal Bevacizumab and Triamcinolone for Neovascular Age-related Macular Degeneration: Six-month Results of a Randomized Clinical Trial." Retina (Philadelphia, Pa.), vol. 31, no. 9, 2011, pp. 1819-26.
Ahmadieh H, Taei R, Riazi-Esfahani M, et al. Intravitreal bevacizumab versus combined intravitreal bevacizumab and triamcinolone for neovascular age-related macular degeneration: six-month results of a randomized clinical trial. Retina (Philadelphia, Pa). 2011;31(9):1819-26.
Ahmadieh, H., Taei, R., Riazi-Esfahani, M., Piri, N., Homayouni, M., Daftarian, N., & Yaseri, M. (2011). Intravitreal bevacizumab versus combined intravitreal bevacizumab and triamcinolone for neovascular age-related macular degeneration: six-month results of a randomized clinical trial. Retina (Philadelphia, Pa.), 31(9), pp. 1819-26. doi:10.1097/IAE.0b013e31820d58f2.
Ahmadieh H, et al. Intravitreal Bevacizumab Versus Combined Intravitreal Bevacizumab and Triamcinolone for Neovascular Age-related Macular Degeneration: Six-month Results of a Randomized Clinical Trial. Retina (Philadelphia, Pa). 2011;31(9):1819-26. PubMed PMID: 21555967.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intravitreal bevacizumab versus combined intravitreal bevacizumab and triamcinolone for neovascular age-related macular degeneration: six-month results of a randomized clinical trial. AU - Ahmadieh,Hamid, AU - Taei,Ramin, AU - Riazi-Esfahani,Mohammad, AU - Piri,Niloufar, AU - Homayouni,Mansour, AU - Daftarian,Narsis, AU - Yaseri,Mehdi, PY - 2011/5/11/entrez PY - 2011/5/11/pubmed PY - 2012/3/22/medline SP - 1819 EP - 26 JF - Retina (Philadelphia, Pa.) JO - Retina (Philadelphia, Pa.) VL - 31 IS - 9 N2 - PURPOSE: To determine whether combined intravitreal bevacizumab (IVB) and triamcinolone (IVT) is more effective than IVB alone in neovascular age-related macular degeneration. METHODS: This was a prospective, randomized clinical trial performed at two centers. Eligible eyes were assigned randomly to one of the two study arms. In the IVB group, 3 consecutive injections of 1.25 mg of bevacizumab were given 6 weeks apart, while in the IVB/IVT group, the first of the triple IVB injections was combined with 2 mg of IVB. A fourth IVB was injected in eyes demonstrating active choroidal neovascularization at Week 24. RESULTS: Sixty and 55 eyes were in the IVB and IVB/IVT groups, respectively. Best-corrected visual acuity improved, and central macular thickness was reduced significantly in both groups at all time points. Visual improvement was more pronounced in the IVB/IVT group compared with the IVB group 6 weeks (8.5 ± 14.4 vs. 3.8 ± 8.9 letters, P = 0.04) and 12 weeks (11.8 ± 16.6 vs. 6.2 ± 10.8 letters, P = 0.03) after initiation of therapy. However, there was no significant difference in visual improvement at Week 24 (11.3 ± 17.2 letters in the IVB/IVT group vs. 8.7 ± 15.6 letters in the IVB group, P = 0.40). The IVB/IVT group showed significantly less need for a fourth injection at Week 24 (34.5% vs. 53.3% in the IVB/IVT and IVB groups, respectively, P = 0.04). CONCLUSION: Mandated therapy with IVB improved best-corrected visual acuity and decreased central macular thickness in neovascular age-related macular degeneration. The addition of low-dose IVT temporarily increased the therapeutic efficacy in the early postinjection period and resulted in fewer requirements for repeat IVB injections at 6 months; however, final levels of visual improvement were comparable in the 2 study groups. SN - 1539-2864 UR - https://www.unboundmedicine.com/medline/citation/21555967/Intravitreal_bevacizumab_versus_combined_intravitreal_bevacizumab_and_triamcinolone_for_neovascular_age_related_macular_degeneration:_six_month_results_of_a_randomized_clinical_trial_ L2 - http://Insights.ovid.com/pubmed?pmid=21555967 DB - PRIME DP - Unbound Medicine ER -