title: [Evaluating the efficacy of anti-VEGF therapy in patients with exudative age-related macular degeneration and concomitant glaucoma].
abstract: OBJECTIVE
  to evaluate the efficacy of anti-VEGF therapy in patients with exudative age-related macular degeneration (AMD) and glaucoma.
  
  
  METHODS
  The study enrolled 117 patients (117 eyes) with exudative AMD and concomitant non-operated primary open-angle glaucoma (POAG). All patients were divided into several groups depending on their intraocular pressure (IOP) and stage of POAG. Hypotensive therapy included carbonic anhydrase inhibitors, beta-adrenergic antagonists (beta blockers) and alpha(2)-adrenergic agonists (alpha-2 mimetics). Lucentis (ranibizumab) was intravitreally injected thrice at monthly intervals. All patients underwent a standard ophthalmic examination, fluorescent retinal angiography, and optical coherence tomography. IOP was measured before the first and after the last injection by means of Icare PRO reboud tonometer.
  
  
  RESULTS
  There was no statistically significant difference between groups Ia, IIa, Ib, and IIb in terms of IOP elevation. Glaucoma IIc and IIIa patients showed just a moderate increase in IOP that did not require regimen adjustment. There was, however, a single IIIb case of persistent IOP elevation, in which one-step penetrating trabeculectomy with intravitreal ranibizumab injection was later performed. Resolution of macular edema was achieved in all patients. Visual acuity (VA) varied between the groups demonstrating a tendency toward improvement in glaucoma Ia patients (p = 0.062) and stabilization in glaucoma IIa (p = 0.61), Ib (p = 0.07), and IIb (p = 0.29) patients. In some cases of low vision at baseline and subretinal fibrosis, VA changes were of no clinical significance.
  
  
  CONCLUSIONS
  Intravitreal ranibizumab therapy proved effective in exudative age-related macular degeneration with concomitant glaucoma. Timely treatment of both AMD (i.e. before the development of subretinal fibrosis) and glaucoma contributes to therapeutic success in these patients.
authors: Research Institute of Eye Diseases, 11 A,B Rossolimo St., Moscow, Russian Federation, 119021.
authors: V P
authors: VP
authors: Erichev
authors: Research Institute of Eye Diseases, 11 A,B Rossolimo St., Moscow, Russian Federation, 119021.
authors: M V
authors: MV
authors: Budzinskaya
authors: Research Institute of Eye Diseases, 11 A,B Rossolimo St., Moscow, Russian Federation, 119021.
authors: M A
authors: MA
authors: Karpilova
authors: Research Institute of Eye Diseases, 11 A,B Rossolimo St., Moscow, Russian Federation, 119021.
authors: A G
authors: AG
authors: Yulova
authors: Research Institute of Eye Diseases, 11 A,B Rossolimo St., Moscow, Russian Federation, 119021.
authors: T V
authors: TV
authors: Smirnova
authors: Research Institute of Eye Diseases, 11 A,B Rossolimo St., Moscow, Russian Federation, 119021.
authors: I V
authors: IV
authors: Andreeva
authors: Research Institute of Eye Diseases, 11 A,B Rossolimo St., Moscow, Russian Federation, 119021.
authors: I V
authors: IV
authors: Shchegoleva
authors: Research Institute of Eye Diseases, 11 A,B Rossolimo St., Moscow, Russian Federation, 119021.
authors: A A
authors: AA
authors: Plyukhova
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D005901:Glaucoma / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D058449:Intravitreal Injections; D000069579:Ranibizumab; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab