Twelve-month results of treatment with intravitreal ranibizumab, intravitreal ranibizumab plus ketorolac eye drops, and intravitreal ranibizumab plus low-fluence photodynamic therapy for exudative age-related macular degeneration
Abstract
Data di Pubblicazione:
2014
Abstract:
Purpose
To compare the effectiveness of treatment with intravitreal ranibizumab (IVR), IVR plus ketorolac eye drops, and IVR plus low-fluence photodynamic therapy (PDT) for choroidal neovascularization (CNV).
Methods
This was a multicenter, prospective, pilot study of eyes with new-onset CNV. Seventy-five eyes were enrolled consecutively and randomized to one of 3 groups at a ratio of 1:1:1. Group 1 (n = 25) received IVR; Group 2 (n = 25) received IVR along with topical ketorolac eye drops 3 times a day; while Group 3 (n = 25) received 1 session of low-fluence PDT followed by IVR. In all groups, ranibizumab 0.5 mg was injected monthly for 3 months, and then as needed in accordance with the standard of care. All patients were followed up for 12 months.
Results
At 12 months, all groups showed significant improvements in best-corrected visual acuity (BCVA; p < 0.001). Group 2 showed a greater mean 12-month BCVA improvement than both groups 1 and 3 (p = 0.049 and p = 0.039, respectively). The mean 12-month change in central macular thickness (CMT) was -131 µm (-29.4%; p < 0.001) in Group 1, -138 µm (-33.4%; p < 0.001) in Group 2, and -129 µm (-29.5%; p < 0.001) in Group 3. Group 2 showed a greater mean CMT reduction than both Groups 1 and 3 (p = 0.002 and p = 0.014, respectively), while anatomical improvements were similar between Groups 1 and 3. None of the 3 groups showed any adverse effects.
Conclusions
This is the first study to report better BCVA outcomes over a 12-month period with a combination of 0.45% ketorolac eye drops 3 times a day and IVR in patients with CNV, further indicating that topical ketorolac supplements the CMT-reducing activity of IVR in CNV. A combination therapy of PDT plus ranibizumab injections did not yield anatomical or functional improvements; however, fewer ranibizumab injections were required. Larger trials are needed to confirm the findings of this pilot study.
To compare the effectiveness of treatment with intravitreal ranibizumab (IVR), IVR plus ketorolac eye drops, and IVR plus low-fluence photodynamic therapy (PDT) for choroidal neovascularization (CNV).
Methods
This was a multicenter, prospective, pilot study of eyes with new-onset CNV. Seventy-five eyes were enrolled consecutively and randomized to one of 3 groups at a ratio of 1:1:1. Group 1 (n = 25) received IVR; Group 2 (n = 25) received IVR along with topical ketorolac eye drops 3 times a day; while Group 3 (n = 25) received 1 session of low-fluence PDT followed by IVR. In all groups, ranibizumab 0.5 mg was injected monthly for 3 months, and then as needed in accordance with the standard of care. All patients were followed up for 12 months.
Results
At 12 months, all groups showed significant improvements in best-corrected visual acuity (BCVA; p < 0.001). Group 2 showed a greater mean 12-month BCVA improvement than both groups 1 and 3 (p = 0.049 and p = 0.039, respectively). The mean 12-month change in central macular thickness (CMT) was -131 µm (-29.4%; p < 0.001) in Group 1, -138 µm (-33.4%; p < 0.001) in Group 2, and -129 µm (-29.5%; p < 0.001) in Group 3. Group 2 showed a greater mean CMT reduction than both Groups 1 and 3 (p = 0.002 and p = 0.014, respectively), while anatomical improvements were similar between Groups 1 and 3. None of the 3 groups showed any adverse effects.
Conclusions
This is the first study to report better BCVA outcomes over a 12-month period with a combination of 0.45% ketorolac eye drops 3 times a day and IVR in patients with CNV, further indicating that topical ketorolac supplements the CMT-reducing activity of IVR in CNV. A combination therapy of PDT plus ranibizumab injections did not yield anatomical or functional improvements; however, fewer ranibizumab injections were required. Larger trials are needed to confirm the findings of this pilot study.
Tipologia CRIS:
1.5 Abstract in rivista
Keywords:
intravitreal ranibizumab,mketorolac eye drops, low-fluence photodynamic therapy, AMD
Elenco autori:
Russo, Andrea; Costagliola, Ciro; Delcassi, Luisa; Romano, Mario R; Turano, Raffaele; Semeraro, Francesco
Link alla scheda completa:
Pubblicato in: