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A RETROSPECTIVE ANALYSIS OF TRIPLE COMBINATION THERAPY WITH INTRAVITREAL BEVACIZUMAB, POSTERIOR SUB-TENON'S TRIAMCINOLONE ACETONIDE, AND LOW-FLUENCE VERTEPORFIN PHOTODYNAMIC THERAPY IN PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION

Kovacs, Kyle D AB*; Quirk, Matthew T AB*; Kinoshita, Taiga MD*; Gautam, Shiva PhD*; Ceron, Olga M MD*; Murtha, Timothy J MD*†; Arroyo, Jorge G MD, MPH*

doi: 10.1097/IAE.0b013e3181f6391f
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Purpose: To assess the efficacy of triple combination therapy (TCT) including bevacizumab (BEV), low-fluence photodynamic therapy, and posterior sub-Tenon's triamcinolone acetonide in patients with wet age-related macular degeneration.

Methods: This institutional review board-approved retrospective consecutive case series included 31 eyes treated for wet age-related macular degeneration with TCT at the Beth Israel Deaconess Medical Center between June 2004 and November 2008. Outcome measures included visual acuity, retinal thickness as measured by optical coherence tomography, time to retreatment, and complications.

Results: Triple combination therapy eyes showed significant 3-month and 6-month improvement in visual acuity of 0.140 ± 0.273 logarithm of the minimum angle of resolution and 0.182 ± 0.383 logarithm of the minimum angle of resolution after treatment, respectively (P = 0.0219 and 0.0470, respectively). Central retinal thickness significantly improved at 3 months (−123.8 ± 102.7 μm), 6 months (−87.7 ± 99.8 μm), and 12 months (−101.6 ± 103.3 μm) on optical coherence tomography. Half of eyes that underwent TCT required retreatment by the conclusion of their follow-up, and eyes that underwent TCT had a 1-year Kaplan-Meier survival rate of 62.1 ± 10.8%.

Conclusion: Triple combination therapy (TCT) appears to effectively improve visual acuity and decrease retinal thickness often without need for subsequent retreatment within the first year of follow-up. Further investigation of TCT in prospective trials is warranted.

Triple combination therapy (TCT) appears to effectively improve visual acuity and decrease retinal thickness often without need for subsequent retreatment within the first year of follow-up. Further investigation of TCT in prospective trials is warranted.

From the *Division of Ophthalmology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and †Retina Service, Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts.

Supported in part by funds from the Beth Israel Deaconess Medical Center Retina Service and the Grimshaw-Gudewicz Charitable Foundation and a research grant from the Novartis Pharmaceuticals.

The authors have no conflicts of interest to disclose.

Reprint requests: Jorge G. Arroyo, MD, MPH, Retina Service, Division of Ophthalmology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215; e-mail: jarroyo@bidmc.harvard.edu

© The Ophthalmic Communications Society, Inc.