April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Comparison of visual acuity outcomes and ranibizumab treatment exposure in East-Asian and Caucasian patients with visual impairment due to myopic CNV: a RADIANCE study subgroup analysis
Author Affiliations & Notes
  • Timothy Lai
    The Chinese University of Hong kong, Shatin, Hong Kong
  • Kyoko Ohno-Matsui
    Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University,, Tokyo, Japan
  • Tien Y Wong
    Singapore Eye Research Institute, Singapore National Eye Centre, National University of Singapore, Singapore, Singapore
  • Paolo Lanzetta
    Department of Ophthalmology, University of Udine, Udine, Italy
  • Stefan Pilz
    Novartis Pharma AG, Basel, Switzerland
  • Nikol Heinrichs
    Novartis Pharma AG, Basel, Switzerland
  • Footnotes
    Commercial Relationships Timothy Lai, Alcon (R), Allergan (C), Allergan (R), Bausch & Lomb (C), Bausch & Lomb (R), Bayer (C), Bayer (R), Novartis (C), Novartis (R); Kyoko Ohno-Matsui, Bayer (C), Novartis (C), Novartis (F); Tien Wong, Abbott (C), Allergan (C), Bayer (C), Bayer (F), Bayer (R), Genentech (C), Novartis (C), Novartis (F), Novartis (R), Pfizer (C), Roche (C); Paolo Lanzetta, Alcon (C), Allergan (C), Bausch & Lomb (C), Bayer (C), Iridex (P), Novartis (C), Roche (C), Teva (C); Stefan Pilz, Novartis (E); Nikol Heinrichs, Novartis (E)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4959. doi:
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    • Get Citation

      Timothy Lai, Kyoko Ohno-Matsui, Tien Y Wong, Paolo Lanzetta, Stefan Pilz, Nikol Heinrichs, ; Comparison of visual acuity outcomes and ranibizumab treatment exposure in East-Asian and Caucasian patients with visual impairment due to myopic CNV: a RADIANCE study subgroup analysis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4959.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Pathologic myopia (PM) is one of the leading causes of blindness. Visual impairment due to PM is more common in East-Asians (12.2-27.4%) than Caucasians (5.8-7.8%); with approximately 10% of East-Asians and 5% of Caucasians developing myopic choroidal neovascularization (CNV). Currently it is unclear whether there is difference in treatment for myopic CNV between East-Asians and Caucasians. The RADIANCE study demonstrated that ranibizumab treatment led to rapid and sustained best-corrected visual acuity (BCVA) improvement in patients with visual impairment due to myopic CNV. We performed a post-hoc, exploratory subgroup analysis of treatment outcome and exposure comparing East-Asian and Caucasian patients of this study.

 
Methods
 

In the RADIANCE study patients (N=277) were randomized 2:2:1 to Group (G)-1 (ranibizumab treatment guided by VA stabilization), G2 (ranibizumab treatment guided by disease activity), or G3 (vPDT and as of Month [M] 3, ranibizumab and/or vPDT at investigator’s discretion). Of the randomized patients, BCVA outcomes and treatment exposure of the East-Asian (n=35) and Caucasian (n=70) patients of G2 (which was the basis for the proposed and approved label for treatment of visual impairment due to myopic CNV) were analyzed. Key outcome measures were mean change in BCVA from baseline and number of injections up to 12M.

 
Results
 

Baseline demographics and ocular characteristics of the study eye analyzed were well balanced across the subgroups (East-Asians vs Caucasians); mean age (54.2 vs 58.0 years); gender (female: 80.0% vs 75.7%), baseline BCVA (54.2 vs 55.9 letters), axial length (28.4 vs 28.9 mm), refraction sphere (10.7 vs 11.8 diopters) and lesion size (2.8 vs 2.5 mm2). At M12, the East-Asian patients gained 16.1 early treatment diabetic retinopathy study (ETDRS) letters with a median of 2.0 (mean: 2.9) injections while the Caucasian patients gained 14.1 ETDRS letters with a median of 3.0 (mean: 3.8) injections (Table).

 
Conclusions
 

East-Asian patients with myopic CNV showed numerically higher BCVA gains with one less injection than Caucasians over 12 months. Further analysis is required to explore underlying reasons and the potential predictors of BCVA outcomes and number of injections in these ethnic groups.

 
 
Mean BCVA change and number of injections up to M12
 
Mean BCVA change and number of injections up to M12
 
Keywords: 453 choroid: neovascularization • 605 myopia • 754 visual acuity  
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