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

Yukari Shirakata, Chieko Shiragami, Ayana Yamashita, Eri Nitta, Atsushi Fujiwara, Fumio Shiraga

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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/cm2 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.

Original languageEnglish
Pages (from-to)599-607
Number of pages9
JournalJapanese Journal of Ophthalmology
Issue number6
Publication statusPublished - Nov 1 2012



  • Bevacizumab
  • Photodynamic therapy
  • Reduced laser fluence
  • Retinal angiomatous proliferation
  • Triamcinolone acetonide

ASJC Scopus subject areas

  • Ophthalmology

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