Long-term visual acuity in patients with age-related macular degeneration and persistence of subretinal fluid after treatment with ranibizumab

• Published in: Archivos de la Sociedad Española de Oftalmología Vol. 87; no. 8; pp. 237 - 246
• Main Authors: Torrón, C, Fernández-Pérez, S, Ruiz, O, Leciñena, J, Pablo, L
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-08-2012
• Subjects: Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - therapeutic use; Follow-Up Studies; Humans; Macular Degeneration - drug therapy; Ranibizumab; Subretinal Fluid; Visual Acuity
• ISSN: 1989-7286
• DOI: 10.1016/j.oftal.2012.04.010

To analyse the long-term visual acuity (VA) in patients with age-related macular degeneration (ARMD) treated with ranibizumab, and who had persistent subretinal fluid after the induction therapy and/or in the successive controls.
We reviewed the medical records, optical coherence tomography (OCT) and fluorescein angiograms of 216 patients treated with ranibizumab between January 2008 and April 2010, selecting those who had persistent subretinal fluid or recurrent fluid for at least one year of follow-up.
A total of 36 eyes from 34 patients were included, with 19 eyes (52.7%) having persistent, and 17 (47.2%) recurrent subretinal fluid throughout the follow- up (mean 29.06±9.28 months). The average number of injections was 7.89±3.2. The central macular thickness (CMT) at the start of follow-up was 330±84μm, at 3 months 265.2±62μm, and 294.5±37μm at the end of the follow-up. The initial mean VA was 0.3±0.2, at 3 months 0.43±0.2 (P<.05) and at the final review, 0.41±0.22 (P<.05). Haemorrhages in recurrences were associated with a worse final VA (P=.004). At the end of follow-up, 18 eyes (50%) continued with ranibizumab treatment, 16 eyes (44%) were kept under observation, and 2 patients died. There were no differences between VA and CMT between the groups.
The persistence or recurrence of macular subretinal fluid in patients treated with ranibizumab does not significantly reduce the visual gain obtained after induction therapy, despite discontinuation of treatment during follow-up. Haemorrhages in the recurrences were associated with a worse final VA.