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Response to additional applied dexamethasone in patients with persistent or recurrent choroidal neovascularization secondary to age-related macular degeneration

Session Details

Session Title: AMD III

Session Date/Time: Sunday 20/09/2015 | 11:00-13:00

Paper Time: 11:40

Venue: Athena

First Author: : S.Rezar AUSTRIA

Co Author(s): :    K. Eibenberger   W. Buehl   M. Georgopoulos   C. Krall   U. SchmidtErfurth   S. Sacu

Abstract Details

PURPOSE:To evaluate the functional and morphological response of persistent or recurrent neovascular age-related macular degeneration (nAMD) to additional dexamethasone intravitreal implants (Ozurdex®).

Setting:

Prospective, randomized, clinical trial. All patients were recruited at the Department of Ophthalmology, Medical Unversity of Vienna.

Methods:

40 eyes of 40 consecutive patients with persistent or recurrent intraretinal and/or subfoveal fluid after initial ranibizumab treatment were included. The follow-up was 12-months. We randomly assigned the patients (1:1) to receive either intravitreal ranibizumab monotherapy (IVM) or dexamethasone and ranibizumab combination therapy (IVC). In the second group a dexamethasone intravitreal implant was additionally admistered at baseline and after 6 months earliest in case of missing disease stability. Functional and morphological response to treatment and re-treatment rate was compared and analyzed over the 12 months period.

Results:

Patients were included after mean of 11.7 and 11.9 months in IVM/ IVC group after initial treatment and received a mean amount of 5.6┬▒3.4 and 6.7┬▒4.4 IVM/ IVC ranibizumab injections before inclusion, respectively. IVM resolved macula edema in 30% and IVC therapy resolved macula edema in 65% (p=0.027; chisquare test). This effect was found to be stable until a median time of 2/4 months in the IVM/IVC-group. Median time until the second ranibizumab re-treatment differed significantly (p=0.0042; logrank-test) between the groups. Functional parameter remained stable in both groups with no significant differences (visual acuity: 62/68 seen letters at baseline; 67/68 after 12 months, p=0.68; macular sensitivity: 6.95/7.24 and 7.01/7.12dB, p=0.4). Central retinal thickness decreased, however, with no significance between the groups (486/439 at baseline; 453/368 after 12 months; p=0.38).

Conclusions:

Combination therapy resulted in significant greater morphological response of persistent or recurrent choroidal neovascularization. Significant delay in re-treatment was found in patients treated with additional dexamethasone. Functional and morphological parameters were stable over the 12 months period.

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