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Medical Abstracts 265

These findings suggest that second-eneration FDP has the diagnostic abilityo detect abnormalities in those with earlyo moderate glaucomatous visual fieldamage. Evidence also suggests that FDPay be more sensitive to early glaucoma-

ous loss. In this study, FDP showed highensitivity and specificity when comparedith SAP. The question of whether FDP

an detect glaucomatous visual field lossooner than SAP cannot be answered byhis study alone. Researchers suggest lon-itudinal studies monitoring early glauco-atous visual field progression would bet-

er address this issue.

Jason Price, O.D.

doi:10.1016/j.optm.2007.04.090

ore options for thereatment of ARMD

ugustin AJ, Puls S, Offerman I.riple therapy for choroidal neovas-ularization due to age-related mac-lar degeneration: verteporfin PDT,evacizumab, and dexamethasone.etina 2007;27(2):133-40.

horoidal neovascularization (CNV)

esulting from age-related macular de- b

eneration (ARMD) often is visuallyevastating. Over the last few years,everal treatments have been utilizedo reduce the associated ocular morbid-ty of CNV. Photodynamic therapyPDT) was seen as a significant ad-ancement in the treatment of CNV;owever, it was not without drawbacksuch as cost, need for repeated treat-ents, side effects, and patient incon-

enience. Intravitreal injections of cor-icosteroids (triamcinolone) have beenombined with PDT in the treatment ofNV with modest success. With this inind, the authors set out to determine

f adding the vascular endothelialrowth factor (VEGF) inhibitor bev-cizumab (Avastin; Genentech, Inc.,an Francisco, California) to the treat-ent regimen would prove beneficial.

n addition, the corticosteroid dexa-ethasone was used instead of triam-

inolone for its reduced side effects.One hundred four patients with all

ypes of CNV secondary to ARMDere included. Each patient underwent

he “triple procedure” of PDT, dexa-ethasone, and Avastin injection.ighteen patients had an additional in-

ection of Avastin, and 5 patients hadhe “triple therapy” regimen repeated

ecause of the reactivity of the CNV.

he overall mean visual acuity im-roved by 1.8 lines. A total of 39.4%f the participants improved 3 lines orore, whereas only 3.8% decreased 3

ines or more. Additionally, no severedverse events were reported, and noncreases in intraocular pressures werebserved after a 40-week mean fol-ow-up period.

The results of this study are sim-lar to the results reported ononthly monotherapy via anti-VEGF

ntravitreal injections. However, ane-time “triple therapy” procedureould prove to be desirable if it re-uces cost, increases patient conve-ience, and decreases potential sideffects. Although the authors attesthat the particular treatment regimensn this study may not be optimal, nourrently available single treatmentegimen addresses the multifactorialathogenesis of CNV. In the contextf treating ARMD, these are excitingimes. Patients as well as practitio-ers now have more options, puttingne of the world’s leading causes oflindness on notice.

Barry J. Frauens, O.D.

doi:10.1016/j.optm.2007.04.091