Combination of ranibizumab and indomethacin for neovascular age-related macular degeneration: randomized controlled trial

Andrea Russo,1 Nicolò Scaroni,1 Elena Gambicorti,1 Raffaele Turano,1 Francesco Morescalchi,1 Ciro Costagliola,2 Francesco Semeraro1 1Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Brescia, 2Eye Clinic, Department of Health Sciences, University of Molis...

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Autores principales:	Russo A, Scaroni N, Gambicorti E, Turano R, Morescalchi F, Costagliola C, Semeraro F
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	central retinal thickness choroidal neovascularization indomethacin inflammation ranibizumab. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/518ce34b357b4dd59c15b9b40bbc3471
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spelling	oai:doaj.org-article:518ce34b357b4dd59c15b9b40bbc34712021-12-02T02:31:41ZCombination of ranibizumab and indomethacin for neovascular age-related macular degeneration: randomized controlled trial1177-5483https://doaj.org/article/518ce34b357b4dd59c15b9b40bbc34712018-03-01T00:00:00Zhttps://www.dovepress.com/combination-of-ranibizumab-and-indomethacin-for-neovascular-age-relate-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Andrea Russo,1 Nicolò Scaroni,1 Elena Gambicorti,1 Raffaele Turano,1 Francesco Morescalchi,1 Ciro Costagliola,2 Francesco Semeraro1 1Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Brescia, 2Eye Clinic, Department of Health Sciences, University of Molise, Campobasso, Italy Purpose: The aim of this study was to evaluate whether indomethacin eye drops and intravitreal ranibizumab (IVR) injections would provide additional benefit over ranibizumab alone in the treatment of choroidal neovascularization (CNV). Participants and methods: This was a randomized, prospective pilot study of eyes with new-onset CNV. Fifty-eight patients were randomized 1:1 into a ranibizumab monotherapy (RM) group and a ranibizumab plus indomethacin (RI) group. All patients received monthly 0.5 mg IVR injections for 3 months, followed by monthly injections administered as needed. RI group patients also self-administered one drop of 0.5% indomethacin three times a day for 12 months. All patients were followed up for 12 months. Results: At 12 months, both groups showed significant improvement in best-corrected visual acuity (BCVA) and central retinal thickness (CRT). The mean BCVA change from baseline to 12 months was -0.12±0.04 LogMAR and -0.20±0.04 LogMAR in the RM and RI groups, respectively, with the degree of change being significantly different between the two groups (P=0.04). At 12 months, the mean CRT in the RM group (316±41.2 µm) was significantly higher than that in the RI group (287±31.5 µm; P=0.004). The mean required number of IVR injections was 7.38±0.78 and 6.34±0.67 in the RM and RI groups, respectively (P<0.001). Conclusion: Compared to IVR monotherapy, combination therapy with indomethacin eye drops and IVR provides superior anatomical and visual outcomes in patients with naive CNV lesions. Moreover, topical indomethacin might reduce the frequency of IVR injections, which is very beneficial considering the chronic and expensive nature of IVR therapy. Keywords: central retinal thickness, choroidal neovascularization, indomethacin, inflammation, ranibizumabRusso AScaroni NGambicorti ETurano RMorescalchi FCostagliola CSemeraro FDove Medical Pressarticlecentral retinal thicknesschoroidal neovascularizationindomethacininflammationranibizumab.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 587-591 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	central retinal thickness choroidal neovascularization indomethacin inflammation ranibizumab. Ophthalmology RE1-994
spellingShingle	central retinal thickness choroidal neovascularization indomethacin inflammation ranibizumab. Ophthalmology RE1-994 Russo A Scaroni N Gambicorti E Turano R Morescalchi F Costagliola C Semeraro F Combination of ranibizumab and indomethacin for neovascular age-related macular degeneration: randomized controlled trial
description	Andrea Russo,1 Nicolò Scaroni,1 Elena Gambicorti,1 Raffaele Turano,1 Francesco Morescalchi,1 Ciro Costagliola,2 Francesco Semeraro1 1Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Brescia, 2Eye Clinic, Department of Health Sciences, University of Molise, Campobasso, Italy Purpose: The aim of this study was to evaluate whether indomethacin eye drops and intravitreal ranibizumab (IVR) injections would provide additional benefit over ranibizumab alone in the treatment of choroidal neovascularization (CNV). Participants and methods: This was a randomized, prospective pilot study of eyes with new-onset CNV. Fifty-eight patients were randomized 1:1 into a ranibizumab monotherapy (RM) group and a ranibizumab plus indomethacin (RI) group. All patients received monthly 0.5 mg IVR injections for 3 months, followed by monthly injections administered as needed. RI group patients also self-administered one drop of 0.5% indomethacin three times a day for 12 months. All patients were followed up for 12 months. Results: At 12 months, both groups showed significant improvement in best-corrected visual acuity (BCVA) and central retinal thickness (CRT). The mean BCVA change from baseline to 12 months was -0.12±0.04 LogMAR and -0.20±0.04 LogMAR in the RM and RI groups, respectively, with the degree of change being significantly different between the two groups (P=0.04). At 12 months, the mean CRT in the RM group (316±41.2 µm) was significantly higher than that in the RI group (287±31.5 µm; P=0.004). The mean required number of IVR injections was 7.38±0.78 and 6.34±0.67 in the RM and RI groups, respectively (P<0.001). Conclusion: Compared to IVR monotherapy, combination therapy with indomethacin eye drops and IVR provides superior anatomical and visual outcomes in patients with naive CNV lesions. Moreover, topical indomethacin might reduce the frequency of IVR injections, which is very beneficial considering the chronic and expensive nature of IVR therapy. Keywords: central retinal thickness, choroidal neovascularization, indomethacin, inflammation, ranibizumab
format	article
author	Russo A Scaroni N Gambicorti E Turano R Morescalchi F Costagliola C Semeraro F
author_facet	Russo A Scaroni N Gambicorti E Turano R Morescalchi F Costagliola C Semeraro F
author_sort	Russo A
title	Combination of ranibizumab and indomethacin for neovascular age-related macular degeneration: randomized controlled trial
title_short	Combination of ranibizumab and indomethacin for neovascular age-related macular degeneration: randomized controlled trial
title_full	Combination of ranibizumab and indomethacin for neovascular age-related macular degeneration: randomized controlled trial
title_fullStr	Combination of ranibizumab and indomethacin for neovascular age-related macular degeneration: randomized controlled trial
title_full_unstemmed	Combination of ranibizumab and indomethacin for neovascular age-related macular degeneration: randomized controlled trial
title_sort	combination of ranibizumab and indomethacin for neovascular age-related macular degeneration: randomized controlled trial
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/518ce34b357b4dd59c15b9b40bbc3471
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Combination of ranibizumab and indomethacin for neovascular age-related macular degeneration: randomized controlled trial

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