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Nashila Hirji, Anchal Kailey, Benita Dhanasekaran, Maria Dimitry, Manju Chandran, Geeta Menon; Ranibizumab For Neovascular Age-Related Macular Degeneration Unresponsive To Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2012;53(14):856.
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To assess the safety and efficacy of ranibizumab in patients with choroidal neovascularisation (CNV) who had inadequate response to bevacizumab.
In this retrospective single-centre study, the case notes of 100 patients initially treated with intravitreal bevacizumab for CNV secondary to age-related macular degeneration (AMD), were reviewed. Patients who demonstrated an inadequate clinical response to bevacizumab, and who were therefore switched to treatment with monthly ranibizumab, were identified. Inadequate clinical response was defined as a gain of less than 1 line of visual acuity (VA) as measured on an Early Treatment Diabetic Retinopathy Study (ETDRS) chart, or a persistence of 300μm or greater central macular thickness (CMT) on optical coherence tomography (OCT) following intravitreal injection of bevacizumab. Patients who demonstrated an inadequate clinical response at two consecutive visits, despite adequate response at other visits, were switched to ranibizumab. At each clinic visit, VA and CMT were recorded. The VA and CMT following the final bevacizumab injection and monthly ranibizumab after the third injection were compared to assess the change in these parameters following the switch to ranibizumab.
Forty-three patients were identified as having been switched to treatment with ranibizumab. Following the switch, VA increased by a mean of 10.00 ± 2.01 letters (± standard error of the mean). Twenty patients (46.5%) gained 10 or more letters, 22 (51.2%) remained stable, and 1 (2.3%) lost more than 15 letters. CMT decreased by a mean of 22.35 ± 7.35µm (± standard error of the mean). No drug- or injection-related adverse events were reported.
Ranibizumab is a safe and effective treatment in patients with AMD who show inadequate response to bevacizumab.
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