A randomized controlled trial of ranibizumab with and without indomethacin eyedrops for exudative age-related macular degeneration

Purpose To assess whether indomethacin eye drops and intravitreal ranibizumab (IVR) would provide additional benefit over IVR alone in the treatment of naïve choroidal neovascularization (CNV). Methods A total of 22 patients were enrolled consecutively and randomized in a 1:1 ratio to receive combination treatment with monthly IVR and topical indomethacin or monthly IVR alone. Results At 6 months, both groups showed a significant improvement in BCVA. The mean change in central macular thickness (CMT) in the combination group was −129.2 μm (−30.1%; P < .01), while in the ranibizumab-only group, the change was −86.9 mm (−21.1%; P < .01); thus, the combination treatment resulted in a greater reduction (P = .004). Conclusion This pilot study, the first to prospectively investigate the efficacy and safety of a combination of 0.5% indomethacin eye drops and IVR injections in patients with CNV, suggests that topical indomethacin supplements the activity of IVR in reducing CMT in CNV