Topical bromfenac as an adjunctive treatment with intravitreal ranibizumab for exudative age-related macular degeneration

• Published in: Retina (Philadelphia, Pa.) Vol. 32; no. 9; p. 1804
• Main Authors: Gomi, Fumi, Sawa, Miki, Tsujikawa, Motokazu, Nishida, Kohji
• Format: Journal Article
• Language: English
• Published: United States 01.10.2012
• Subjects: Administration, Topical; Aged; Aged, 80 and over; Angiogenesis Inhibitors - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Antibodies, Monoclonal, Humanized - therapeutic use; Benzophenones - administration & dosage; Bromobenzenes - administration & dosage; Double-Blind Method; Drug Therapy, Combination; Exudates and Transudates; Female; Fluorescein Angiography; Humans; Intravitreal Injections; Male; Middle Aged; Ranibizumab; Tomography, Optical Coherence; Treatment Outcome; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity - physiology; Wet Macular Degeneration - diagnosis; Wet Macular Degeneration - drug therapy; Wet Macular Degeneration - physiopathology
• ISSN: 1539-2864
• DOI: 10.1097/IAE.0b013e31825be87f

Intravitreal injection of ranibizumab is highly effective for wet age-related macular degeneration. Its limitation is that most patients require repeated intravitreal injections to achieve and maintain the visual gain. We assessed the effectiveness of adjunctive topical bromfenac, a nonsteroidal antiinflammatory drug, with ranibizumab. Patients with wet age-related macular degeneration with lesions smaller than 2 disk diameters were randomized 2:3 to adjunctive topical bromfenac (n = 16) or sham (n = 22) and a 0.5-mg ranibizumab injection in a double-masked fashion. Subjects were examined monthly, and ranibizumab was injected as needed from baseline. The primary endpoint was the comparison of the number of ranibizumab injections over 6 months. The visual and anatomic responses also were compared. The mean number of ranibizumab injections over 6 months was 2.2 in the bromfenac group and 3.2 in the sham, a difference that reached significance (P = 0.0274). The changes in visual acuity did not differ significantly (P = 0.3141) although the central retinal thickness was tended to decrease more in bromfenac group (P = 0.0604). Multivariate analysis showed that topical bromfenac is significantly associated with fewer ranibizumab injections. Topical bromfenac might reduce the frequency of ranibizumab over 6 months in eyes with relatively small age-related macular degeneration lesions.