[Exsudative AMD: Regression analysis of transpupillary thermotherapy with and without intravitreal injection of triamcinolone, bevacizumab and ranibizumab].
OBJECTIVE
The aim of this study was to evaluate therapies for exsudative age-related macular degeneration (AMD) in a regression analysis. Transpupillary thermotherapy (TTT) with and without intravitreal injection (IVI) of triamcinolone, IVI of bevacizumab, and ranibizumab was investigated.


METHODS
413 patients with an at least 6-month control were included in this retrospective single-centre study. 209 patients were treated with TTT, 36 received TTT with IVI of triamcinolone, and 70 avastin. All subjects underwent a full ophthalmological examination including fluorescein angiography (FA) at baseline and after 1, 3 and every 6 months. All patients were re-treated immediately after FA if necessary using the same method with ophthalmological controls starting again one month after therapy. 98 patients were treated with IVI of Lucentis. Lucentis patients received an upload with three injections and entered the examination protocol thereafter. Taking into account the natural course of exsudative AMD, therapies started at an advanced stage of the disease. Main outcome measures were best corrected visual acuity (log MAR), mean defect (MD), and pattern standard deviation (PSD) in a 10° visual field threshold test. The time-dependent course was estimated by linear regression analysis and tested for significant differences by pairs. A two-tailed α = 0.05 was considered significant.


RESULTS
Linear regression analysis demonstrated a moderate loss of visual functions in each therapy. Linear regressions did not show significant differences between the therapies with regard to log MAR, MD, and PSD. Taking into account the natural course of exsudative AMD, the contemporary therapy with ranibizumab is initiated earlier than the previous therapies.


CONCLUSIONS
Linear regression analysis of an advanced stage of exsudative AMD did not reveal any significant differences between TTT with and without IVI of triamcinolone, IVI of bevacizumab, and ranibizumab in a clinical setting. As therapies are expected to be more efficious in an early stage of disease, a macula screening is recommended.
Weber
U
U
Augenklinik, Städtisches Klinikum Braunschweig. u.weber@klinikumbraunschweig.de
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000628:therapy*; D008297:Male; D000069579:Ranibizumab; D012189:Retrospective Studies; D014221:Triamcinolone / Q000008:administration & dosage* / Q000009:adverse effects; D014794:Visual Fields / Q000187:drug effects
D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014221:Triamcinolone; D000068258:Bevacizumab; D000069579:Ranibizumab