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Raeba Mathew, Richard Leung, Sobha Sivaprasad; Can Patients On ranibizumab Therapy For Neovascular Age Related Macular Degeneration Predict Reactivation Of Disease?. Invest. Ophthalmol. Vis. Sci. 2011;52(14):107.
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To assess the ability of the patient to predict the need for retreatment with intravitreal Ranibizumab in neovascular age related macular degeneration (NV AMD).
A questionnaire was given to 96 patients (100 eyes) undergoing Optical Coherence Tomography (OCT) guided re-treatment with intravitreal Ranibizumab injections following an initial loading regimen of 3 injections for NVAMD. The patients were asked about their opinion on the need for an injection on the current visit, based on their perception of visual deterioration or distortion. The opinion of the patient was then compared to the change of vision between the present and preceding visit and the presence of fluid on OCT. The sensitivity and specificity of patient prediction was analysed.
The ability of patients to predict disease activity showed a sensitivity of 65.7% and specificity of 92.9%. The area under the ROC curve was 0.8. The test had apositive predictive value of 92.5% and a negative predictive value of 80%. The presence of intra retinal or subretinal fluid correlated well with the patients’ perception. Intra retinal fluid was a better marker for symptomatic visual decline compared to subretinal fluid.
In real life, patients are able to predict the reactivation of the disease in NV AMD, which correlated well with the visual acuity change and morphological characteristics on OCT.
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