A RETROSPECTIVE ANALYSIS OF TRIPLE COMBINATION THERAPY WITH INTRAVITREAL BEVACIZUMAB, POSTERIOR SUB-TENON’S TRIAMCINOLONE ACETONIDE, AND LOW-FLUENCE VERTEPORFIN PHOTODYNAMIC THERAPY IN PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION KYLE D. KOVACS, AB,* MATTHEW T. QUIRK, AB,* TAIGA KINOSHITA, MD,* SHIVAGAUTAM, PHD,* OLGA M. CERON, MD,* TIMOTHY J. MURTHA, MD,*† JORGE G. ARROYO, MD, MPH* Purpose: To assess the efficacy of triple combination therapy (TCT) including bevacizumab (BEV), low-fluence photodynamic therapy, and posterior sub-Tenon’s triamcinolone acetonide in patients with wet age-related macular degeneration. Methods: This institutional review board–approved retrospective consecutive case series included 31 eyes treated for wet age-related macular degeneration with TCT at the Beth Israel Deaconess Medical Center between June 2004 and November 2008. Outcome measures included visual acuity, retinal thickness as measured by optical coherence tomography, time to retreatment, and complications. Results: Triple combination therapy eyes showed significant 3-month and 6-month improvement in visual acuity of 0.140 6 0.273 logarithm of the minimum angle of resolution and 0.182 6 0.383 logarithm of the minimum angle of resolution after treatment, respectively (P = 0.0219 and 0.0470, respectively). Central retinal thickness significantly improved at 3 months (2123.8 6 102.7 mm), 6 months (287.7 6 99.8 mm), and 12 months (2101.6 6 103.3 mm) on optical coherence tomography. Half of eyes that underwent TCT required retreatment by the conclusion of their follow-up, and eyes that underwent TCT had a 1-year Kaplan–Meier survival rate of 62.1 6 10.8%. Conclusion: Triple combination therapy (TCT) appears to effectively improve visual acuity and decrease retinal thickness often without need for subsequent retreatment within the first year of follow-up. Further investigation of TCT in prospective trials is warranted. RETINA 31:446–452, 2011 A ge-related macular degeneration (AMD) is the leading cause of blindness in people aged .50 years in industrialized countries. 1–3 Neovascular (wet) AMD results from abnormal blood vessels growing in and under the retina, and although it represents only 10% to 20% of all cases of AMD, it accounts for 80% to 90% of AMD-associated vision loss. 4 There are now a variety of treatment options that are known to be effective in suppressing growth of these vessels and improving visual acuity outcomes. Recent AMD studies have not only compared the various treatment options individually but also have explored the possible benefits of combining therapies to target the multiple steps in the pathogenesis of AMD. A combination approach in treating the age-related inflammation that stimulates choroidal neovascularization (CNV), the angiogenic 446