One-year results of bevacizumab intravitreal and posterior sub-Tenon injection of triamcinolone acetonide with reduced laser fluence photodynamic therapy for retinal angiomatous proliferation.

PURPOSE: Our aim was to study the efficacy of combined triple therapy with intravitreal bevacizumab injections (IVB), posterior sub-Tenon injection of triamcinolone acetonide (STTA), and reduced laser fluence photodynamic therapy (RFPDT) in Japanese patients with retinal angiomatous proliferation (RAP).

DESIGN: This was a retrospective, observational, consecutive case series.

METHODS: Fifteen consecutive RAP treatment-naïve eyes were treated with triple therapy of IVB, STTA, and RFPDT (25 J/cm(2) of laser fluence). Whenever there was a recurrence of retinal-retinal anastomosis (RRA) or retinal-choroidal anastomosis (RCA) and marked leakage from subretinal neovascularization, the triple therapy was reapplied. When there were only intraretinal exudative and/or hemorrhagic changes without distinct RRA or RCA, IVB alone was applied.

RESULTS: The mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) at baseline improved significantly (from 0.489 to 0.294 12 months) (paired t test, p = 0.043). LogMAR BCVA at 12 months was stable or improved by ≥ 0.2 in 14 eyes (93.3 %). Mean number of triple therapy instituted during the 12-month study period was 1.2, and mean number of IVB treatments was 1.4.

CONCLUSION: Combined IVB, STTA, and RFPDT for RAP was effective in maintaining or improving VA at 1 year. In addition, the number of treatments could be markedly reduced.