These factors include, but are not limited to, increased production of VEGF, intracellular adhesion molecule, matrix metalloproteinase, monocyte colonizing protein, interleukin-8, and free radical production. Indeed, biochemical and histological analyses of extracted membranes, as well as numerous animal models, clearly demonstrate that broad-spectrum inflammation is present in the milieu surrounding these membranes. Subclassification into neovascular and nonneovascular does little to highlight the diverse, multidimensional nature of the processes involved in the development of choroidal neovascular (CNV) membranes.
#BAY AREA RETINA ASSOCIATES TRIAL#
Augustin, MD, should be duly credited with developing a triple-therapy protocol that also incorporates a monoport vitrectomy.) We will also provide interm results of the PDEX trial, a prospective, randomized trial evaluating the relative efficacy of triple therapy versus a monthly ranibizumab (Lucentis Genentech South San Francisco) regimen.ĪMD is a comprehensive term that encompasses a broad spectrum of macro- and microscopic alterations to the retina and retinal pigment epithelium (RPE) in patients aged >50 years. We subsequently developed a triple-therapy protocol with the further addition of an anti-vascular endothelial growth factor (VEGF) agent.
In a step-wise fashion, we first used this agent in combination with verteporfin photodynamic therapy (PDT) (Visudyne Novartis, Hanover, NJ) alone to determine its safety profile and whether there was any added efficacy compared with PDT alone.
Within this review, we would like to discuss our rationale for introducing intravitreal dexamethasone as an adjunct in the treatment of neovascular age-related macular degeneration (AMD).
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