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Ramu Muniraju, Jayashree Ramu, Sobha Sivaprasad; Outcomes of Second eye Versus First eye in Patients Treated with Ranibizumab for Bilateral Neovascular Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):250.
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To assess the time to conversion of wet AMD in the fellow eye and compare the visual outcomes between first and second eyes in patients with bilateral neovascular AMD (nAMD).
Retrospective analysis of case notes of patients with bilateral neovascular AMD treated with ranibizumab monotherapy with at least 12 months follow up was done. Visual Acuity (VA) at baseline and at 12 months, number of injections for both first and the second eyes and the time interval of conversion to nAMD of second eye were recorded. SPSS software version 18 was used to perform regression analysis where change in VA of second eye was a dependent variable and the predictors were the age, injection frequency, time interval between first and second eye and the VA at baseline.
A total of 49 patients with bilateral sequential nAMD treated with ranibizumab monotherapy had completed 12 months follow up. Mean age at presentation of the first eye was 83.3 years ± 7.4, majority were females (60%). The mean time interval of conversion to nAMD in the second eye was 11.2 ± 8.1 months and the median time interval was 10 months (range 1-30 months). The mean baseline VA of first eye was 46.8 ± 14.5 letters while that of second eye was 58.8 ± 14.6 letters. The mean change of VA in first eye was +1.7 ± 16.7 (p<0.01) letters while that of second eye was -2.3 ± 14.7 letters (p<0.03). The mean final VA at 12 months of first and second eyes was 48.8 ± 20.1 letters and 56.5 ± 19.1 letters respectively. The mean number of injections in the first eye was 5 ± 2 and the second eye was 4.9 ± 1.9. Regression analysis showed that the time interval between first and the second eye significantly (p<0.001) influenced the change in VA of the second eyes, where longer intervals was associated with better VA. Baseline VA (P<0.001) and the number of injections (p<0.05) were the other significant predictors of change in VA of second eyes.
Second eyes have better baseline VA, but there were no significant difference in mean change in VA in first and second eye at 12 months. Longer the time interval of conversion to nAMD between first and second eyes, the better was the final visual acuity of the second eyes.
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