Table 2: Studies investigating NSAIDs in combination with anti-VEGF.

StudyDesign, sample size, and study durationNSAIDTreatment armsResultsAuthor conclusions

Russo et al. (2013) [7]Randomized, prospective, controlled,
56 eyes
6 months
Ketorolac 0.45% TIDKetorolac plus IVR versus IVR alone for new exudative AMD37.1 µm greater CMT reduction at 6 months in ketorolac arm. No differences for VA or no. of injectionsTopical ketorolac supplements the activity of intravitreal ranibizumab in reducing CMT in CNV
Gomi et al. (2012) [5]Randomized, prospective, placebo-controlled,
30 eyes
6 months
Bromfenac 0.1% BIDBromfenac plus IVR versus IVR alone for exudative AMDReduced CMT and fewer injections in bromfenac group, but similar VABromfenac may reduce the frequency of IVR over
6 months in eyes with small CNV
Flaxel et al. (2012) [4]Randomized, prospective, controlled,
30 eyes
12 months
Bromfenac 0.09% BIDBromfenac plus IVR versus IVR alone for exudative AMD63.3 µm greater CMT reduction at 12 months in bromfenac arm. No differences for VA or no. of injectionsCombination
is efficacious for the treatment of exudative AMD
Chen et al. (2010) [32]Retrospective, uncontrolled
25 eyes
3 months
Nepafenac 0.1% TIDNepafenac plus IVR/IVB for recalcitrant exudative AMDNo changes in VA or CMT No significant changes in VA or CMR, but a mild trend towards improved anatomy
Zweifel et al. (2009) [33]Retrospective, uncontrolled
22 eyes
2 months
Bromfenac 0.09% BIDBromfenac plus IVR/IVB for persistent exudative AMDNo changes in VA or CMTNo beneficial effect of adding bromfenac for persistent exudative AMD

AMD: age-related macular degeneration; CNV: choroidal neovascularization; VA: visual acuity; CMT: central macular thickness; IVR: intravitreal ranibizumab; IVB: intravitreal bevacizumab.