Comparison of intravitreal triamcinolone acetonide with photodynamic therapy and intravitreal bevacizumab with photodynamic therapy for retinal angiomatous proliferation

Am J Ophthalmol. 2010 Mar;149(3):472-81.e1. doi: 10.1016/j.ajo.2009.09.016. Epub 2010 Jan 6.

Abstract

Purpose: To compare the efficacy of combined therapy with intravitreal triamcinolone (IVTA) and photodynamic therapy (PDT; IVTA plus PDT) with intravitreal bevacizumab (IVB) and PDT (IVB plus PDT) for patients with retinal angiomatous proliferation (RAP).

Design: Retrospective, observational case series.

Methods: We retrospectively reviewed 25 treatment-naïve eyes of 22 Japanese patients (11 men, 11 women) with retinal angiomatous proliferation. Twelve eyes of 11 patients were treated with combined therapy of IVTA plus PDT from September 1, 2004, through July 31, 2006. Thirteen eyes of 11 patients were treated with combined therapy of IVB plus PDT from February 1, 2007, through January 31, 2008.

Results: In 12 eyes treated with IVTA plus PDT, the mean best-corrected visual acuity (BCVA) levels at baseline and 12 months were 0.29 and 0.13, respectively. A significant (P < .05) decline in the mean BCVA from baseline was observed at 12 months. In 13 eyes treated with IVB plus PDT, the mean BCVA levels at baseline and 12 months were 0.25 and 0.37. A significant (P < .05) improvement in the mean BCVA from baseline was observed. At 12 months, the difference in BCVA between the 2 groups was significant (P < .05). The mean numbers of treatments at 12 months in the IVTA plus PDT group and the IVB plus PDT group were 2.7 and 1.6, respectively. The difference between the 2 treatments reached significance (P < .05). No complications developed.

Conclusions: Compared with IVTA plus PDT, IVB plus PDT was significantly more effective in maintaining and improving visual acuity and in reducing the number of treatment for patients with retinal angiomatous proliferation.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use*
  • Angiomatosis / diagnosis
  • Angiomatosis / drug therapy*
  • Angiomatosis / physiopathology
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Coloring Agents
  • Combined Modality Therapy
  • Female
  • Fluorescein Angiography
  • Glucocorticoids / therapeutic use*
  • Humans
  • Indocyanine Green
  • Injections
  • Male
  • Middle Aged
  • Photochemotherapy*
  • Retinal Neovascularization / diagnosis
  • Retinal Neovascularization / drug therapy*
  • Retinal Neovascularization / physiopathology
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Triamcinolone Acetonide / therapeutic use*
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology
  • Vitreous Body

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Coloring Agents
  • Glucocorticoids
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Triamcinolone Acetonide
  • Indocyanine Green