Visual Outcome After Intravitreal Ranibizumab for Wet Age-Related Macular Degeneration

Squirrell, David; Mawer, Nick P.; Mody, Christopher H.; Brand, Christopher

doi:10.1097/iae.0b013e3181bd2f29

Cited by 33 publications

(32 citation statements)

References 21 publications

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“…[4][5][6][7][8] However, this is the first study, to our knowledge, that examines whether micro- perimetry is useful for detecting functional changes in the early stages of AMD over a relatively short follow-up period of 12 months. In this present study, we found that microperimetry was able to detect changes in sensitivity to luminance increments over a 12-month period for eyes that either remained stable or showed disease progression in the early stages of AMD.…”

Section: Discussionmentioning

confidence: 90%

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Longitudinal Changes in Microperimetry and Low Luminance Visual Acuity in Age-Related Macular Degeneration

Ayton

Luu

et al. 2015

JAMA Ophthalmol

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IMPORTANCEThere is a need for more sensitive measures of disease in intermediate age-related macular degeneration (AMD) to evaluate novel interventions more effectively and expediently.OBJECTIVE To determine if microperimetry and low luminance visual acuity can detect functional changes over a short duration of follow-up. DESIGN, SETTING, AND PARTICIPANTSProspective longitudinal examination of 49 participants with consecutive AMD and 10 healthy participants in a research clinic from May 1, 2012, to December 31, 2013. Forty-one participants had intermediate AMD, 8 had nonfoveal geographic atrophy due to AMD. Participants underwent microperimetry examinations in 1 eye during a 12-month period at 6-month intervals for participants with AMD and at baseline and 12 months for control participants; low luminance visual acuity was performed at baseline and at 12 months for all participants. Changes in pathological features of intermediate AMD eyes were determined using side-by-side comparisons of color fundus photographs from the initial and final visit as remaining stable, progressed, or improved. MAIN OUTCOMES AND MEASURES Microperimetric sensitivity and low luminance visual acuity.RESULTS A reduction in mean (SE) microperimetric pointwise sensitivity was identified at 12 months compared with the baseline for intermediate AMD eyes graded as stable (−0.31 dB [0.10 dB]; P = .003) or worsened (−0.42 dB [0.12 dB]; P < .001) and an improvement in mean (SE) pointwise sensitivity was identified in eyes graded as improved (1.13 dB [0.23 dB]; P < .001). A reduction in mean (SE) pointwise sensitivity was identified in eyes with nonfoveal geographic atrophy at both 6 months (−1.41 dB [0.22 dB]; P < .001) and 12 months compared with the baseline (−2.56 dB [0.22 dB]; P < .001) while a change in mean (SE) pointwise sensitivity was not identified over the 12-month period for control participants (−0.11 dB [0.11 dB]; P = .34). No changes in best-corrected visual acuity or low luminance visual acuity were identified in all groups over the 12-month period (P Ն .07). CONCLUSIONS AND RELEVANCEMicroperimetry detected subtle changes in visual function over a 12-month period in eyes with intermediate AMD but visual acuity measures did not identify any such changes. These findings suggest that microperimetry is worth exploring as a method for assessing the efficacy of novel interventions for intermediate AMD potentially requiring a shorter duration of follow-up.

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Section: Discussionmentioning

confidence: 90%

“…Microperimetry has been used in the atrophic and neovascular stages of AMD. [4][5][6][7][8] In addition to other studies, we have…”

mentioning

confidence: 91%

Longitudinal Changes in Microperimetry and Low Luminance Visual Acuity in Age-Related Macular Degeneration

Ayton

Luu

et al. 2015

JAMA Ophthalmol

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“…[18][19][20] Bolz et al 18 conducted a prospective study to evaluate the functional and morphological effects of three loading doses of intravitreal ranibizumab in 29 patients (29 eyes) with previously untreated nvAMD. Although they observed an improvement in VA, central retinal thickness, and central retinal sensitivity after 1 month, they did not observe any additional benefit following the subsequent second and third injections.…”

Section: Discussionmentioning

confidence: 99%

Microperimetric changes in neovascular age-related macular degeneration treated with ranibizumab

Alexander

Mushtaq

Osmond

et al. 2012

Eye

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Purpose To assess the value of microperimetry in eyes with neovascular age-related macular degeneration previously treated with ranibizumab and now in the maintenance phase of therapy. Methods A total of 21 eyes (14 patients) were included. Microperimetry was performed using the Macular Integrity Assessment Device on at least three occasions for each eye. Intravitreal ranibizumab was administered if visual acuity (VA) or optical coherence tomography (OCT) showed signs of active disease. Results Five eyes showed no change in VA or OCT findings, and required no intravitreal injections. In these eyes, mean threshold sensitivity (TS) decreased by 13% (paired t-test, P ¼ 0.05) during the study period, but fixation stability (FS) was unchanged. In all, 16 eyes showed signs of disease activity, and therefore required ranibizumab injections during the study. In these eyes, VA, central retinal thickness (CRT), FS, and TS remained unchanged during follow-up. Peak TS was noted when CRT was 210 lm; above or below 210 lm, there was a gradual reduction in TS. Conclusion This study has provided novel information on the relationship between macular sensitivity, CRT, and VA in the maintenance phase of ranibizumab therapy. Patients with stable VA and CRT may still have deteriorating retinal sensitivity. This is usually a late manifestation and may indicate subclinical CNV activity.

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“…Microperimetry testing has been done in patients treated with anti-VEGF treatment, and these studies documented an improvement in microperimetry scores with treatment. [34][35][36][37][38][39] The size of the ellipsoid zone defect has previously been associated with decreased microperimetry results in a study of neovascular AMD, 40 but that study did not state if the patients were treated or not. We could find no other studies correlating microperimetry scores with SD-OCT anatomical parameters of the retina or CNV or autofluorescence test results in treated patients in previously published articles.…”

Section: Discussionmentioning

confidence: 97%

Multimodal Imaging Findings and Multimodal Vision Testing in Neovascular Age-Related Macular Degeneration

Sato

Suzuki

Ooto

et al. 2015

Retina

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Visual Outcome After Intravitreal Ranibizumab for Wet Age-Related Macular Degeneration

Abstract: Compared with microperimetry, BCVA seems to significantly underestimate the change in visual function experienced by patients treated with ranibizumab.

Cited by 33 publications

References 21 publications

Longitudinal Changes in Microperimetry and Low Luminance Visual Acuity in Age-Related Macular Degeneration

Longitudinal Changes in Microperimetry and Low Luminance Visual Acuity in Age-Related Macular Degeneration

Microperimetric changes in neovascular age-related macular degeneration treated with ranibizumab

Multimodal Imaging Findings and Multimodal Vision Testing in Neovascular Age-Related Macular Degeneration

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