Intravitreal bevacizumab versus triamcinolone acetonide for exudative age-related macular degeneration.
BACKGROUND
To compare an intravitreal high-dose injection of triamcinolone acetonide with an intravitreal injection of bevacizumab for the treatment of progressive exudative age-related macular degeneration (AMD).


METHODS
The comparative nonrandomized retrospective clinical interventional study included 305 patients with progressive AMD, divided into a bevacizumab group of 36 patients (1.5 mg bevacizumab) and a triamcinolone group of 269 patients (about 20 mg triamcinolone). All patients were consecutively included, in the first phase of the study for triamcinolone, and in the second phase of the study for bevacizumab. The mean follow-up was 8.5+/-6.8 months (2-35.7 months).


RESULTS
In the bevacizumab group, best visual acuity increased significantly (p<0.001) by 3.2+/-3.4 Snellen lines, with 25 (69%) eyes and 21 (58%) eyes, improving by at least 2 and 3 Snellen lines, respectively. In the triamcinolone group, the visual acuity change was not statistically significant for any specific follow-up examination within the first 3 months. The maximal increase in visual acuity, the visual acuity change at 2 months after injection and the percentage of patients with an improvement by at least 2 and 3 Snellen lines were significantly (p<0.001) higher in the bevacizumab group than in the triamcinolone group. Intraocular pressure increased significantly (p<0.001) in the triamcinolone group and did not change significantly (p=0.47) in the bevacizumab group.


CONCLUSIONS
In exudative AMD, intravitreal bevacizumab (1.5 mg) compared with intravitreal triamcinolone acetonide (about 20 mg) results in a higher improvement of visual acuity and does not markedly influence intraocular pressure within 2 months after injection.
Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht Karl University, Heidelberg, Germany. Jost.Jonas@ma.augen.uni-heidelberg.de
Jost B
JB
Jonas
Anna K
AK
Ihloff
Bjoern
B
Harder
Ingrid
I
Kreissig
Frank
F
Schlichtenbrede
Teodosio
T
Libondi
Ulrich H M
UH
Spandau
Urs
U
Vossmerbaeumer
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D007429:Intraocular Pressure / Q000187:drug effects; D008268:Macular Degeneration / Q000188:drug therapy*; D008297:Male; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*; D014792:Visual Acuity / Q000187:drug effects
D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide