Diabetic Macular Edema Clinical Trial
Official title:
Effect of Topical Aqueous Suppressants on Response to Intravitreal Anti-vascular Endothelial Growth Factor Injections in Age-related Macular Degeneration (AMD), Retinal Vein Occlusions (RVO) or Diabetic Macular Edema (DME).
This study seeks to evaluate the effect of topical aqueous suppression on the anatomic and functional response to intravitreal anti-vascular endothelial growth factor (VEGF) injections in non-responders with wet age-related macular degeneration.
Intravitreal anti-vascular endothelial growth factor (VEGF) agents, including bevacizumab,
ranibizumab, and aflibercept, have become the gold standard treatment for neovascular
age-related macular degeneration (AMD). Various treatment modalities using these agents have
been proposed, including monthly, pro re nata, and treat-and-extend philosophies. Despite
frequent and consistent treatment with anti-VEGF therapy, there is a subset of patients who
are incomplete or non-responders and have persistent evidence of exudation on spectral-domain
optical coherence tomography (SD-OCT), including subretinal fluid (SRF) and/or intraretinal
edema.
While clearance of intravitreal anti-VEGF drugs is not completely understood, some studies
have suggested that outflow through the anterior chamber may contribute. We hypothesized that
by decreasing aqueous production, outflow may also be reduced which could delay the clearance
of intravitreal drugs. As a result, we chose topical dorzolamide-timolol since it is a potent
aqueous suppressant and is readily available due to its common use in the treatment of
glaucoma. The current study aimed to evaluate the efficacy of topical dorzolamide-timolol on
anatomic and visual outcomes in anti-VEGF non-responders with neovascular AMD.
Significance: The results of this study will help delineate whether topical aqueous
suppression may be useful as adjuvant therapy in patients receiving chronic intravitreal
anti-VEGF injections.
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