Effectiveness of ranibizumab intravitreal injections for exudative age-related macular degeneration treatment: 12-month outcomes

Abstract

SummaryBackgroundThe aim of this paper was to evaluate functional and anatomical results of intravitreal ranibizumab injections and the course of exudative age-related macular degeneration (AMD) treatment over a 12-month observation period.Material/MethodsIn 25 patients with active dominantly classic exudative AMD, treatment was performed according to the following schedule: 3 intravitreal injections of 0.5 mg ranibizumab at monthly intervals (saturation phase); further injections were based on activity of the neovascular process. Changes in VA and central retinal thickness (CRT) during treatment were evaluated with ANOVA testing.ResultsMean pre-treatment best corrected visual acuity was 0.73±0.27 logMAR. After the third ranibizumab injection the best results, 0.54±0.27 logMAR, were seen; 12-month results were 0.58±0.26 logMAR. Patients had a mean improvement of 10.6 letters at 12 months. In 92% of patients stabilization or improvement of vision was observed. The mean number of injections in the 12-month period was 6.Baseline mean CRT was 351.12±74.15 μm. After the first ranibizumab injection it decreased significantly to 221.96±60.85 μm, after the third injection it was 200.80±47.63 μm, and after 12 months it was 213.16±44.37 μm. Mean correlations between baseline average CRT and baseline average VA measured in ETDRS letters (p=0.017) and in logMAR scale (p=0.033) and between average CRT after the third injection and average VA in logMAR scale after the third injection (p=0.047) were noted.ConclusionsTreatment with intravitreal ranibizumab injections according to the presented scheme provides AMD patients with a chance of stabilization and improvement of the topical state, with a lower number of injections and preserved topical and general safety. Our results suggest that regular monthly controls are necessary to be able react rapidly to the smallest signs of deterioration, not only in visual acuity, but also in OCT images.

Combination of bevacizumab and bromfenac therapy in age-related macular degeneration: A pilot study

“…A long-term follow-up of all patients treated in our clinic shows that further injections do not improve visual acuity, but led to stable visus and efficiently reduced exudation. Similar findings were reported by other studies [ 22 , 23 ].…”

“…For visual acuity, most studies on intravitreal ranibizumab and topical NSAIDs showed improved therapy results. However, the tendencies show that the proper aim of this treatment is to sustain the BCVA [ 8 , 22 ].…”

Antivascular Endothelial Growth Factor Dosing and Expected Acuity Outcome at 1 Year

“…The introduction of antivascular endothelial grow factor (VEGF) agents was a major advance in treating macular neovascularization in age-related macular degeneration. 1–40,41–70,71–96 The magnitude of effect of the anti-VEGF medications ranibizumab 2,61 and aflibercept 94 was apparent from the initial monthly dosing studies. Later studies based on a pro re nata (PRN) or a treat and extend (TE) dosing strategy produced visual acuity results that emulated, after a fashion, what was obtained with monthly dosing.…”

Influence of ranibizumab treatment on the extracellular matrix in patients with neovascular age-related macular degeneration

“…Ranibizumab reduces edema in the central retina [ 9 ]: in 90% to 95% of patients, it stabilizes visual acuity, and in one-third of patients, it improves it [ 8 , 9 ]. It is an effective cure for CNV/AMD [ 8 , 10 , 12 ]; however, it is not devoid of adverse effects [ 10 , 13 , 14 ].…”