Ranibizumab for Predominantly Classic Neovascular Age-related Macular Degeneration: Subgroup Analysis of First-year ANCHOR Results

Brown, David M.; Zhang, Kang; Hudson, Henry L.; Holz, Frank G.; Shapiro, Howard; Schneider, Susan; Acharya, Nisha R.

doi:10.1016/j.ajo.2007.08.012

Cited by 344 publications

(260 citation statements)

References 6 publications

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“…[7][8][9] Given that better visual outcomes are associated with better baseline visual acuities and that health-related quality of life scores are correlated to the better seeing eye, [10][11][12] it is important to strive to diagnose nAMD early and initiate prompt treatment as any delay can result in poorer visual outcomes. 13 Early diagnosis of nAMD remains a clinical challenge.…”

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography changes before the development of choroidal neovascularization in second eyes of patients with bilateral wet macular degeneration

Amissah-Arthur

Panneerselvam

Narendran

et al. 2011

Eye

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Aim To describe the frequency of neovascular age-related macular degeneration (nAMD) in second eyes of patients undergoing ranibizumab therapy in their first eye and to evaluate the patterns of optical coherence tomography (OCT) abnormalities in fellow eyes before nAMD. Method Patients who developed choroidal neovascularization (CNV) in the second eye while on treatment for the first eye were identified. OCT scans of the second eyes, performed before the onset of CNV, were retrospectively examined and graded. Frequency of second eye involvement was estimated and patterns of progression of OCT abnormalities were described and classified. Results In all, 65 out of 749 consecutive patients required ranibizumab in their second eye for treatment-naïve nAMD over a 2-year period. The mean interval from commencement of ranibizumab in first eye to conversion in second eye was 12 months (2-35.5 months). There were three patterns of CNV development: group A (12%, n ¼ 8) had no OCT abnormalities in the second eye just before developing CNV; group B (38%, n ¼ 25) had no abnormalities at baseline but developed OCT changes more than one visit before conversion and group C (50%, n ¼ 32) had OCT changes from baseline, which did not progress until just before conversion. ConclusionPatients with retinal pigment epithelial elevation without sub-retinal fluid on OCT in their fellow eyes have a high risk of progression to require therapy within a 2-year period. An anticipatory approach may be warranted, but a small group with completely normal OCT appearances can still develop lesions between visits.

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Section: Introductionmentioning

confidence: 99%

Optical coherence tomography changes before the development of choroidal neovascularization in second eyes of patients with bilateral wet macular degeneration

Amissah-Arthur

Panneerselvam

Narendran

et al. 2011

Eye

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“…3 An improved understanding of the role of vascular endothelial growth factor (VEGF) in the pathogenesis of choroidal neovascular membranes (CNV) has led to the use of intravitreally administered anti-VEGF antibodies (ranibizumab and bevacizumab) and an aptamer (pegaptanib sodium) in the treatment of these lesions. [4][5][6][7] These new therapies have surpassed previous treatments in both efficacy and safety and are now the standard of care for NV-AMD.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal pegaptanib sodium for choroidal neovascularisation secondary to age-related macular degeneration: Pan-European experience

Sivaprasad

Hykin

Saeed

et al. 2009

Eye

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Purpose To evaluate visual outcomes in patients with neovascular age-related macular degeneration (NV-AMD) who were treated with pegaptanib sodium in European clinical ophthalmology practices. Methods Thirteen centres in eight European countries participated in this retrospective study. Medical records for patients with any angiographic subtype of subfoveal choroidal neovascularisation secondary to NV-AMD with visual acuities (study eye) of 20/40-20/320 treated with 0.3 mg pegaptanib as first-line treatment and with at least 24 weeks of follow-up were identified. Anonymised data reflecting at least 24 and up to 54 weeks of follow-up were recorded. Primary end points were visual acuity outcomes at weeks 24 and 54 compared with those reported at week 54 in the vascular endothelial growth factor (VEGF) Inhibition Study in Ocular Neovascularisation (VISION) trial. Results In all, 253 patients were followed for at least 24 weeks; 62 patients completed 54 weeks of follow-up. A mean of 4.4 (SD, 1.8) pegaptanib injections were administered through 24 weeks. Compared with the VISION trial, the European experience showed that 490% of patients in the current cohort lost o15 letters from baseline at both time points compared with 70% in the VISION trial at 54 weeks. Pegaptanib was well tolerated with no reported cases of endophthalmitis, traumatic cataract, or iatrogenic retinal detachment.Conclusions Pegaptanib was found to stabilise vision in a greater percentage of patients and produced greater overall visual improvement in this group of treatment-naive patients with NV-AMD compared with outcomes reported in the VISION trial; however, interpretation of these results should be tempered given the differences in design between this retrospective study and the prospective controlled trial.

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“…Because anti-VEGF therapy in ARMD has proved beneficial with subfoveal CNV, 6 it might be expected that extrafoveal or juxtafoveal lesions might have similarly favourable outcomes, as suggested by this series. Because of the concern of progression of CNV to frank subfoveal involvement, a maximally aggressive approach with combination therapy, including PDT, was chosen and good outcomes were achieved.…”

Section: Discussionmentioning

confidence: 69%

“…Nevertheless, it is possible that anti-VEGF therapy without PDT might achieve similarly good results in nonfoveal CNV, in light of its superiority to PDT in subfoveal CNV due to ARMD. 6 For this reason, we do not recommend PDT alone for either foveal or nonfoveal ARMD cases. Notably, ARMD eyes required longer courses of treatment than non-ARMD eyes.…”

Section: Discussionmentioning

confidence: 99%

“…5 The function of anti-VEGF and photodynamic therapy (PDT) as a potential alternative to laser treatment in such cases was evaluated to determine if improved outcomes might be expected with these treatments. Although this approach has been reported for subfoveal lesions, [6][7][8] few if any reports exist for juxtafoveal or extrafoveal lesions.…”

Section: Introductionmentioning

confidence: 99%

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Combined intravitreal anti-VEGF and verteporfin photodynamic therapy for juxtafoveal and extrafoveal choroidal neovascularization as an alternative to laser photocoagulation

Han

McAllister

Weinberg

et al. 2009

Eye

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Ranibizumab for Predominantly Classic Neovascular Age-related Macular Degeneration: Subgroup Analysis of First-year ANCHOR Results

Cited by 344 publications

References 6 publications

Optical coherence tomography changes before the development of choroidal neovascularization in second eyes of patients with bilateral wet macular degeneration

Optical coherence tomography changes before the development of choroidal neovascularization in second eyes of patients with bilateral wet macular degeneration

Intravitreal pegaptanib sodium for choroidal neovascularisation secondary to age-related macular degeneration: Pan-European experience

Combined intravitreal anti-VEGF and verteporfin photodynamic therapy for juxtafoveal and extrafoveal choroidal neovascularization as an alternative to laser photocoagulation

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