The role of adjunctive aqueous suppressants for anti-vascular endothelial growth factor therapy: A systematic review.
Kareem Sadek, Philip Yu, Salem Abu Al-Burak et al.
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In 30 seconds
This systematic review evaluated the effectiveness of adjunctive aqueous suppressants alongside anti-VEGF therapy in patients with diabetic macular edema (DME), retinal vein occlusion (RVO), and neovascular age-related macular degeneration (nAMD). The review included 12 studies (7 randomized trials; 495 eyes) and found that while adjunctive dorzolamide may reduce retinal thickness in DME, consistent improvements in visual acuity or treatment burden were not observed.
Key findings
- In DME, 3 of 4 trials showed greater thickness reduction with adjunctive dorzolamide (±timolol).
- In RVO, one trial suggested a transient anatomical benefit from adjunctive therapy.
- In nAMD, dorzolamide-timolol reduced residual fluid but did not improve visual outcomes.
- Topical therapy led to modest IOP reductions without serious adverse events.
Why it matters
Understanding the role of adjunctive aqueous suppressants in anti-VEGF therapy is crucial for optimizing treatment strategies for common retinal conditions. Clinicians need to weigh the potential short-term anatomical benefits against the lack of consistent functional improvements.