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TOPICAL BROMFENAC AS AN ADJUNCTIVE TREATMENT WITH INTRAVITREAL RANIBIZUMAB FOR EXUDATIVE AGE-RELATED MACULAR DEGENERATION

Gomi, Fumi MD; Sawa, Miki MD; Tsujikawa, Motokazu MD; Nishida, Kohji MD

doi: 10.1097/IAE.0b013e31825be87f
Original Study

Purpose: Intravitreal injection of ranibizumab is highly effective for wet age-related macular degeneration. Its limitation is that most patients require repeated intravitreal injections to achieve and maintain the visual gain. We assessed the effectiveness of adjunctive topical bromfenac, a nonsteroidal antiinflammatory drug, with ranibizumab.

Methods: Patients with wet age-related macular degeneration with lesions smaller than 2 disk diameters were randomized 2:3 to adjunctive topical bromfenac (n = 16) or sham (n = 22) and a 0.5-mg ranibizumab injection in a double-masked fashion. Subjects were examined monthly, and ranibizumab was injected as needed from baseline. The primary endpoint was the comparison of the number of ranibizumab injections over 6 months. The visual and anatomic responses also were compared.

Results: The mean number of ranibizumab injections over 6 months was 2.2 in the bromfenac group and 3.2 in the sham, a difference that reached significance (P = 0.0274). The changes in visual acuity did not differ significantly (P = 0.3141) although the central retinal thickness was tended to decrease more in bromfenac group (P = 0.0604). Multivariate analysis showed that topical bromfenac is significantly associated with fewer ranibizumab injections.

Conclusion: Topical bromfenac might reduce the frequency of ranibizumab over 6 months in eyes with relatively small age-related macular degeneration lesions.

We prospectively compared the injection frequency of intravitreal ranibizumab for wet age-related macular degeneration in Japanese with or without topical bromfenac, a nonsteroidal antiinflammatory drug, and found that the adjunctive bromfenac might reduce the injection frequency of ranibizumab during the early phase of treatment.

Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.

Reprint requests: Fumi Gomi, MD, Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan; e-mail: fgomi@ophthal.med.osaka-u.ac.jp

Supported in part by the Japan Society for the Promotion of Science, Tokyo, Japan (Grant-in-Aid for Scientific Research, no. 22591942).

The authors declare no conflict of interest.

This prospective study was registered at the Clinical Trial Registry of the University Hospital Medical Information Network (UMIN-CTR; no. UMIN 000002854).

Senju Pharmaceutical provided eye drops used in this study, but it had no role in the design or conduct of the study.

© The Ophthalmic Communications Society, Inc.