Effects of Ranibizumab in Patients with Subfoveal Choroidal Neovascularization Attributable to Age-related Macular Degeneration

• Published in: American journal of ophthalmology Vol. 147; no. 5; pp. 831 - 837
• Main Authors: Rothenbuehler, Simon P, Waeber, David, Brinkmann, Christian K, Wolf, Sebastian, Wolf-Schnurrbusch, Ute E.K
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-05-2009; Elsevier; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Angiogenesis Inhibitors - administration & dosage; Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal, Humanized; Biological and medical sciences; Choroidal Neovascularization - diagnosis; Choroidal Neovascularization - drug therapy; Choroidal Neovascularization - etiology; Diabetic retinopathy; Eye diseases; Female; Fluorescein Angiography; Fovea Centralis - drug effects; Health Insurance Portability & Accountability Act 1996-US; Humans; Injections; Macular degeneration; Macular Degeneration - complications; Macular Degeneration - diagnosis; Macular Degeneration - drug therapy; Male; Medical sciences; Middle Aged; Miscellaneous; Myopia; Ophthalmology; Pharmaceutical industry; Photodynamic therapy; Prospective Studies; Ranibizumab; Retinopathies; Studies; Tomography, Optical Coherence; Treatment Outcome; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Vision Disorders - prevention & control; Visual Acuity - drug effects; Visual Acuity - physiology; Vitreous Body; Switzerland; Human; Immunomodulator; Eye disease; Retinopathy; Vascular endothelium growth factor; Choroidal neovascularization; Ranibizumab; Age related macular degeneration; Monoclonal antibody; Ophthalmology; Antiangiogenic agent
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2008.12.005

Purpose To demonstrate not only prevention of vision loss but also improvement in best-corrected visual acuity (BCVA) after treatment with ranibizumab on a variable-dosing regimen over 24 months in patients with age-related macular degeneration (AMD). Design Interventional case series. Methods setting: Institutional. study population: One hundred and thirty-eight eyes of 138 patients treated intravitreally with 0.5 mg ranibizumab (Lucentis; Novartis, Basel, Switzerland). Age above 50 years, BCVA 0.2 to 1.2 logarithm of the minimal angle of resolution (logMAR), primary or recurrent subfoveal choroidal neovascularization (CNV) secondary to AMD. observation procedures: After single initial treatment, monthly follow-up examination. Retreatment in case of one of the following: sign of subretinal fluid or intraretinal edema, increase in central retinal thickness (CRT) on optical coherence tomography (OCT), active CNV on fluorescein angiography, increase of metamorphopsia, and loss of BCVA >5 letters on Early Treatment Diabetic Retinopathy Study (ETDRS) chart. main outcome measures: Compared with baseline: proportion of eyes gaining ≥15 letters, proportion of eyes losing or gaining <15 letters, change in CRT. Results After 24 months, 30% of eyes gained ≥15 letters. After 24 months, 55% of eyes lost or gained <15 letters. Mean CRT of 386 ± 145 μm at baseline was significantly reduced to 211 ± 39 μm after 24 months ( P = .036). Mean injection number per patient was 5.6 ± 2.9 and 4.3 ± 3.8 from baseline to month 12 and month 12 to 24, respectively. Conclusion Intravitreal ranibizumab on a variable-dosing regimen was effective in significantly increasing mean BVCA and reducing CRT. This beneficial outcome was achieved with a low-rate of mild ocular adverse effects among our patients.