gms | German Medical Science

Purpose: It was the aim of this study to compare the efficacy of bevacizumab alone versus a combination of low-dose triamcinolone and bevacizumab in the treatment of acute wet AMD.

Methods: Analysis of visual acuity and OCT-CFT development in two non-randomized successive clinical case series either treated with intravitreal bevacizumab (BEV, 1.25 mg) alone or in combination with simultaneous injection of 2 mg triamcinolone (BEV+T). Only treatment naïve patients were included in this study. Analyzed patient groups (BEV, n=32; BEV+T, n=27) did not present significant differences concerning age and basic disease parameters (age, basic visual acuity, type and size of lesion, and CFT) at study entry. Follow-up examinations were performed at days 1 & 7, month 1, 2 & 3 after injection including best corrected visual acuity (BCVA), IOP, slit lamp examination, binocular funduscopy and OCT. Fluorescence angiography was performed before treatment and after 3 months.

Results: BCVA presented a transient improvement of 0.3 log lines at 4 weeks and was -0.1 log lines below entry at 3 months in BEV. BEV+T resulted in an improvement of visual of acuity of 0.8 log lines at 1 & 2 months and 0.5 at the end of follow-up. CFT was significantly decreased at month 1 & 2 in BEV but no longer at month 3. Significant CFT reduction persisted in BEV+T patients for the whole study period (p < 0.0001). Transient secondary ocular hypertension occurred in 1/32 BEV, and 4/27 BEV+T patients.

Conclusions: Preliminary results of this follow-up study indicate that low-dose intravitreal triamcinolone in addition to bevacizumab is resulting in a prolongation of functional benefit and structural benefit in cases with acute exsudative age related macular degeneration.