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Lucia Gonzalez-Buendia, M.Rosa Sanabria, Iztiar Fernandez, Santiago Delgado-Tirado, Rosa Coco, ; PREDICTIVE FACTORS OF VISUAL IMPROVEMENT IN EXUDATIVE AMD PATIENTS AFTER 4 YEARS OF AS NEEDED RANIBIZUMAB TREATMENT . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2827.
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© ARVO (1962-2015); The Authors (2016-present)
The analysis of predictive factors of visual improvement in exudative AMD after monthly treatment with ranibizumab has been performed. In this study we wanted to identify predictive factors of visual improvement in wet AMD after loading dose and pro re nata (PRN) treatment over 4 years.
Retrospective case series of 253 eyes with neovascular AMD from 7 centers in Castilla y León treated with three initial monthly injections and thereafter a PRN treatment over 2-4 years. Main outcome measurement was Snellen distance best-corrected visual acuity (VA) transformed to logMAR. SD-OCT analysis was performed in each patient at each visit. Statistical analysis was performed using R Statistical Software.
We analyzed 253 eyes. Mean age 77.97 years. Mean follow-up was 37.53 months. Fifty-nine eyes (23.32%) showed VA improvement. The presence of a small area of fibrosis at baseline [OR=10.32 (95%CI: 2.55-41.85)] and presence of a minimum area of atrophy at baseline [OR=8.85 (95%CI: 1.31-59.80)] were associated with a higher probability of VA improvement. On the other hand, urban origin [OR=0.19 (95%CI: 0.04-0.96)] and persistence of subretinal fluid (SRF) on the OCT at the 1st year visit [OR=0.39 (95%CI: 0.18-0.84)] were associated with a lower probability of visual improvement. Delay in onset of treatment of more than 90 days, longer time of follow-up and higher number of injections performed during the first 2 years of treatment showed a trend towards less VA improvement but did not achieve statistical significance.
This study examined the predictors of vision improvement in one of the largest cohort of European exudative AMD patients treated on an as needed basis with long follow-up. Presence of a small area of fibrosis or atrophy at baseline was associated with greater VA improvement, whereas the presence of SRF after 1 year of treatment and urban origin, were associated with lesser improvement.
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