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Bromfenac alone or with single intravitreal injection of bevacizumab or triamcinolone acetonide for treatment of uveitic macular edema

  • Inflammatory Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the efficacy of bromfenac drops alone or with a single intravitreal injection of bevacizumab (IVB) or triamcinolone acetonide (IVTA) in the treatment of uveitic macular edema (UME).

Design

Comparative case series.

Study Participant

Sixty-seven eyes (of 55 patients) with UME that received either bromfenac drops alone (n = 34), IVB plus bromfenac (n = 21) or IVTA plus bromfenac (n = 12).

Methods

Chart review of patients at the Massachusetts Eye Research and Surgery Institution (MERSI) was done. Eyes that received either bromfenac drops alone (Br), IVB plus bromfenac (IVB/Br) or IVTA plus bromfenac (IVTA/Br), with follow-up of up to 3 months, were included.

Main Outcome Measure

Visual acuity.

Results

There was no statistically significant effect seen in VA or CMT in the Br group, with 17 of 34 eyes (50 %) needing re-injection before 3 months of follow-up. Mean change in CMT at 4 weeks for the Br group was 5.06 µm. Compared to baseline, both the IVTA/Br and IVB/Br groups showed significant decrease in CMT and improvement in VA at 1 and 3 months follow-up. There was also a continuous decrease in CMT up to 3 months of follow-up with the IVTA/Br group, which was found to be significant in comparison with the IVB/Br group; this trend was not seen in the IVB/Br group at 3 months. The greatest mean change in CMT at 1 month was seen in the IVTA/Br group (154.33 ±178.22 µm), and this was statistically significant in comparison with the other groups (p = <0.0001). However, in terms of mean change in VA, there was no change in the Br group (0.01 ± 0.11 VA logMAR), and only 0.12 ± 0.19 and 0.15 ± 0.20 in the IVB/Br and IVTA/Br groups, respectively.

Conclusion

IVB and IVTA are both effective in improving VA and decreasing CMT up to 3 months. Bromfenac is ineffective alone for UME treatment, but may have a synergistic effect with IVTA in reducing CMT up to 3 months of follow-up.

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Authors and Affiliations

  1. Massachusetts Eye Research and Surgery Institution (MERSI), 8th Floor, 5 Cambridge Center, Cambridge, MA, 02142, USA

    Alaa E. Radwan, Cheryl A. Arcinue, Paul Yang, Pichaporn Artornsombudh & C. Stephen Foster

  2. Ocular Immunology and Uveitis Foundation, Cambridge, MA, USA

    Alaa E. Radwan, Cheryl A. Arcinue, Paul Yang, Pichaporn Artornsombudh & C. Stephen Foster

  3. Department of Ophthalmology, Harvard Medical School, Boston, MA, USA

    C. Stephen Foster

  4. Department of Rheumatology and Rehabilitation, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt

    Esam M. Abu Al-Fadl

Authors
  1. Alaa E. Radwan
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  2. Cheryl A. Arcinue
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  3. Paul Yang
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  4. Pichaporn Artornsombudh
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  5. Esam M. Abu Al-Fadl
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  6. C. Stephen Foster
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Correspondence to C. Stephen Foster.

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Radwan, A.E., Arcinue, C.A., Yang, P. et al. Bromfenac alone or with single intravitreal injection of bevacizumab or triamcinolone acetonide for treatment of uveitic macular edema. Graefes Arch Clin Exp Ophthalmol 251, 1801–1806 (2013). https://doi.org/10.1007/s00417-013-2309-4

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  • DOI: https://doi.org/10.1007/s00417-013-2309-4

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