title: One-year results of bevacizumab intravitreal and posterior sub-Tenon injection of triamcinolone acetonide with reduced laser fluence photodynamic therapy for retinal angiomatous proliferation.
abstract: OBJECTIVE
  Our aim was to study the efficacy of combined triple therapy with intravitreal bevacizumab injections (IVB), posterior sub-Tenon injection of triamcinolone acetonide (STTA), and reduced laser fluence photodynamic therapy (RFPDT) in Japanese patients with retinal angiomatous proliferation (RAP).
  
  
  METHODS
  This was a retrospective, observational, consecutive case series.
  
  
  METHODS
  Fifteen consecutive RAP treatment-naïve eyes were treated with triple therapy of IVB, STTA, and RFPDT (25 J/cm(2) of laser fluence). Whenever there was a recurrence of retinal-retinal anastomosis (RRA) or retinal-choroidal anastomosis (RCA) and marked leakage from subretinal neovascularization, the triple therapy was reapplied. When there were only intraretinal exudative and/or hemorrhagic changes without distinct RRA or RCA, IVB alone was applied.
  
  
  RESULTS
  The mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) at baseline improved significantly (from 0.489 to 0.294 12 months) (paired t test, p = 0.043). LogMAR BCVA at 12 months was stable or improved by ≥ 0.2 in 14 eyes (93.3 %). Mean number of triple therapy instituted during the 12-month study period was 1.2, and mean number of IVB treatments was 1.4.
  
  
  CONCLUSIONS
  Combined IVB, STTA, and RFPDT for RAP was effective in maintaining or improving VA at 1 year. In addition, the number of treatments could be markedly reduced.
authors.affiliation: Department of Ophthalmology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe Miki-cho, Kagawa 761-0793, Japan. y-shira@med.kagawa-u.ac.jp
authors.forename: Yukari
authors.initials: Y
authors.lastname: Shirakata
authors.forename: Chieko
authors.initials: C
authors.lastname: Shiragami
authors.forename: Ayana
authors.initials: A
authors.lastname: Yamashita
authors.forename: Eri
authors.initials: E
authors.lastname: Nitta
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fujiwara
authors.forename: Fumio
authors.initials: F
authors.lastname: Shiraga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D004396:Coloring Agents; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007208:Indocyanine Green; D007267:Injections; D058449:Intravitreal Injections; D008297:Male; D010778:Photochemotherapy; D012008:Recurrence; D015861:Retinal Neovascularization / Q000188:drug therapy* / Q000503:physiopathology; D019233:Retreatment; D012189:Retrospective Studies; D058475:Tenon Capsule / Q000187:drug effects; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide; D007208:Indocyanine Green