Retrospective review of the efficacy of topical bromfenac (0.09%) as an adjunctive therapy for patients with neovascular age-related macular degeneration.

Abstract

PURPOSE:

The purpose of this study was to assess the efficacy of topical bromfenac (0.09%) as an adjunctive therapy for patients with neovascular age-related macular degeneration demonstrating persistent exudation despite monthly intravitreal antivascular endothelial growth factor therapy.

METHODS:

Twenty-one patients (22 eyes) who manifested persistent subretinal and/or intraretinal fluid after at least 3 monthly intravitreal injections of ranibizumab or bevacizumab were prescribed topical bromfenac (0.09%) ophthalmic solution twice daily for 2 months. The efficacy of topical bromfenac was evaluated by comparing visual acuity (logarithm of the minimal angle of resolution and Snellen equivalent), masked readings of spectral domain optical coherence tomography center-point retinal thickness, and the height of pigment epithelial detachment (when present) at baseline and at 1 month and 2 months after the initiation of combined treatment.

RESULTS:

The mean visual acuity logarithm of the minimal angle of resolution (Snellen equivalent) at baseline was 0.55 +/- 0.35 (20/70), and it did not change significantly after 1 month (0.53 +/- 0.35; P = 0.41, paired Student's t-test) or 2 months (0.52 +/- 0.34; P = 0.26) after the initiation of combined treatment. The mean central retinal thickness was 311 microm at baseline, 308 microm (P = 0.73, paired Student's t-test) after 1 month, and 299 microm (P = 0.34) after 2 months. In 20 eyes of 19 patients manifesting a pigment epithelial detachment, the mean pigment epithelial detachment height was 275 microm at baseline, 271 microm (P = 0.33, paired Student's t-test) at 1 month, and 274 microm (P = 0.76) at 2 months. There were no adverse events associated with the extended administration of topical bromfenac.

CONCLUSION:

In patients with neovascular age-related macular degeneration manifesting persistent exudation despite monthly intravitreal antivascular endothelial growth factor therapy, we could not detect a beneficial effect of adding topical bromfenac (0.09%) twice daily over 2 months.

• Authors: Sandrine A Zweifel, Michael Engelbert, Samira Khan, K Bailey Freund
• Journal: Retina (Philadelphia, Pa.) (Retina) 2009 Nov-Dec Vol. 29 Issue 10 Pg. 1527-31 ISSN: 1539-2864 [Electronic] United States
• PMID: 19898185 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Angiogenesis Inhibitors
• Anti-Inflammatory Agents, Non-Steroidal
• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Benzophenones
• Bromobenzenes
• Vascular Endothelial Growth Factor A
• Bevacizumab
• bromfenac
• Ranibizumab

Topics

• Administration, Topical
• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (administration & dosage)
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, adverse effects)
• Antibodies, Monoclonal (administration & dosage)
• Antibodies, Monoclonal, Humanized
• Benzophenones (administration & dosage, adverse effects)
• Bevacizumab
• Bromobenzenes (administration & dosage, adverse effects)
• Choroidal Neovascularization (drug therapy, physiopathology)
• Drug Therapy, Combination
• Exudates and Transudates
• Female
• Humans
• Injections
• Macular Degeneration (drug therapy, physiopathology)
• Male
• Middle Aged
• Ranibizumab
• Retinal Detachment (etiology)
• Retinal Pigment Epithelium (pathology)
• Retrospective Studies
• Treatment Outcome
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity (physiology)
• Vitreous Body