Retrospective review of the efficacy of topical bromfenac (0.09%) as an adjunctive therapy for patients with neovascular age-related macular degeneration.
OBJECTIVE
The purpose of this study was to assess the efficacy of topical bromfenac (0.09%) as an adjunctive therapy for patients with neovascular age-related macular degeneration demonstrating persistent exudation despite monthly intravitreal antivascular endothelial growth factor therapy.


METHODS
Twenty-one patients (22 eyes) who manifested persistent subretinal and/or intraretinal fluid after at least 3 monthly intravitreal injections of ranibizumab or bevacizumab were prescribed topical bromfenac (0.09%) ophthalmic solution twice daily for 2 months. The efficacy of topical bromfenac was evaluated by comparing visual acuity (logarithm of the minimal angle of resolution and Snellen equivalent), masked readings of spectral domain optical coherence tomography center-point retinal thickness, and the height of pigment epithelial detachment (when present) at baseline and at 1 month and 2 months after the initiation of combined treatment.


RESULTS
The mean visual acuity logarithm of the minimal angle of resolution (Snellen equivalent) at baseline was 0.55 +/- 0.35 (20/70), and it did not change significantly after 1 month (0.53 +/- 0.35; P = 0.41, paired Student's t-test) or 2 months (0.52 +/- 0.34; P = 0.26) after the initiation of combined treatment. The mean central retinal thickness was 311 microm at baseline, 308 microm (P = 0.73, paired Student's t-test) after 1 month, and 299 microm (P = 0.34) after 2 months. In 20 eyes of 19 patients manifesting a pigment epithelial detachment, the mean pigment epithelial detachment height was 275 microm at baseline, 271 microm (P = 0.33, paired Student's t-test) at 1 month, and 274 microm (P = 0.76) at 2 months. There were no adverse events associated with the extended administration of topical bromfenac.


CONCLUSIONS
In patients with neovascular age-related macular degeneration manifesting persistent exudation despite monthly intravitreal antivascular endothelial growth factor therapy, we could not detect a beneficial effect of adding topical bromfenac (0.09%) twice daily over 2 months.
Zweifel
Sandrine A
SA
LuEsther T Mertz Retinal Research Center, New York, NY, USA.
Engelbert
Michael
M
Khan
Samira
S
Freund
K Bailey
KB
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D001577:Benzophenones / Q000008:administration & dosage* / Q000009:adverse effects; D000068258:Bevacizumab; D001969:Bromobenzenes / Q000008:administration & dosage* / Q000009:adverse effects; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012163:Retinal Detachment / Q000209:etiology; D055213:Retinal Pigment Epithelium / Q000473:pathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001577:Benzophenones; D001969:Bromobenzenes; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; C053083:bromfenac; D000069579:Ranibizumab