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首页> 外文期刊>Canadian journal of ophthalmology >Triple therapy for neovascular age-related macular degeneration (verteporfin photodynamic therapy, intravitreal dexamethasone, and intravitreal bevacizumab).
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Triple therapy for neovascular age-related macular degeneration (verteporfin photodynamic therapy, intravitreal dexamethasone, and intravitreal bevacizumab).

机译：三联疗法治疗与年龄有关的新血管性黄斑变性（verteporfin光动力疗法，玻璃体内地塞米松和玻璃体内贝伐单抗）。

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OBJECTIVE: Age-related macular degeneration is a multifactorial disease involving inflammation, neovascularization, and vascular leakage. As a result, a rationale exists for investigating combination treatments that target the different pathological processes involved in this disease. We propose triple therapy consisting of verteporfin photodynamic therapy (PDT), intravitreal bevacizumab, and intravitreal dexamethasone. DESIGN: Retrospective chart review. PARTICIPANTS: Thirty-two eyes of 30 patients were included. None of the patients demonstrated concurrent eye pathology, and none of the patients had received previous treatment for their choroidal neovascularization. METHODS: One cycle of triple therapy consisted of reduced-fluence PDT (300 mW/cm(2) for 83 seconds to deliver 25 J/cm(2)) followed immediately by an 800 microg (0.08 mL) intravitreal dexamethasone (IVD) injection. At 1 and 7 weeks after PDT and IVD, patients received a 1.25 mg (0.05 mL) bevacizumab injection. At 13 weeks after PDT and IVD, each patient had a repeat optical coherence tomography and fluorescein angiography to assess choroidal neovascularization activity. Patients were followed for 12 months. RESULTS: The mean number of treatment cycles was 1.4. The mean number of bevacizumab injections was 2.8. Visual acuity improved from 0.74 (SD 0.33) logMAR (20/100) to 0.53 (SD 0.32) logMAR (20/70) (p < 0.005). Foveal thickness decreased from 328 (SD 116) microm to 216 (SD 85) microm (p < 0.001). Ninety-four percent of patients lost fewer than 3 lines, 31% gained more than 3 lines, and 6% lost more than 3 lines. CONCLUSIONS: By combining agents with complementary mechanisms of action, triple therapy could maintain visual acuity and macular anatomy while allowing a reduction in the number of anti-vascular endothelial growth factor injections required.
机译：目的：年龄相关性黄斑变性是一种多因素疾病，涉及炎症，新血管形成和血管渗漏。结果，存在研究针对这种疾病涉及的不同病理过程的联合治疗的理由。我们提议三联疗法，包括维替泊芬光动力疗法（PDT），玻璃体内贝伐单抗和玻璃体内地塞米松。设计：回顾性图表审查。参与者：包括30例患者的32眼。没有患者表现出并发的眼部病理，并且没有患者接受过脉络膜新生血管的先前治疗。方法：三联疗法的一个周期包括降低通量的PDT（300 mW / cm（2）持续83秒以递送25 J / cm（2）），然后立即进行800微克（0.08 mL）玻璃体内地塞米松（IVD）注射。在PDT和IVD后1和7周，患者接受1.25 mg（0.05 mL）贝伐单抗注射。在PDT和IVD后13周，每位患者均进行了重复的光学相干断层扫描和荧光素血管造影，以评估脉络膜新血管形成活性。随访患者12个月。结果：平均治疗周期为1.4。贝伐单抗注射剂的平均数为2.8。视敏度从0.74（SD 0.33）logMAR（20/100）提高到0.53（SD 0.32）logMAR（20/70）（p <0.005）。中央凹厚度从328（SD 116）微米降低到216（SD 85）微米（p <0.001）。 94％的患者丢失了少于3条线，31％的患者获得了超过3条线，6％的患者丢失了超过3条线。结论：通过结合具有互补作用机制的药物，三联疗法可以维持视敏度和黄斑解剖结构，同时减少所需的抗血管内皮生长因子注射次数。

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