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Spencer M Onishi, Josh O Wallsh, Ron P Gallemore, Masumi Asahi; Effect of repeat intravitreal ranibizumab injections on the progression of geographic atrophy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4988.
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To determine whether geographic atrophy (GA) progression is impacted by repeated intravitreal ranibizumab injections in patients with exudative age-related macular degeneration (AMD).
A retrospective chart review of eyes diagnosed with exudate AMD associated with GA, receiving at least 3 consecutive intravitreal ranibizumab injections. High resolution optical coherence tomography (HR-OCT) sub-retinal pigment epithelium (sub-RPE) slab assessment was used to measure area of GA at the initial injection and visit immediately following the final injection. Consecutive ranibizumab injections were counted and visual acuity was measured in logarithm of minimum angle of resolution (logMAR) assessed at initial injection and visit immediately following the final injection.
Eleven eyes from ten patients were included following treatment with an average of 14.6 ± 3.2 (9.1 per year) injections. The mean area of GA increased significantly from 3.8 ± 0.9 to 6.1 ± 0.9 mm2 over a mean of 1.65 ± 0.4 years (p < 0.05). Enlargement rate of GA for included eyes was found to be 2.0 ± 1.7 mm2/year. Overall, studied eyes experienced a mean decrease in visual acuity from 0.74 ± 0.15 to 0.86 ± 0.15 logMAR (p = 0.14).
Progression of GA is not influenced by repeated intravitreal ranibizumab injections with an enlargement rate comparable to levels previously seen in untreated patients. A literature review revealed a previously reported enlargement rate from 1.2 to 2.5 mm2/year in eyes with GA associated with nonexudative AMD. Even with the increase in area of GA, these patients on average loss less than a line of vision over the study duration.
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