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Sarah Sabour-Pickett, James Loughman, John M. Nolan, Konrad Pesudovs, Stephen Beatty; Prognostic Indicators And Outcome Measures For Patients With Neovascular Age-related Macular Degeneration Undergoing Treatment With Intravitreal Ranibizumab. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4397.
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To assess visual function, and its response to serial intravitreal ranibizumab (Lucentis, Genentech), in patients with neovascular age-related macular degeneration (nv-AMD).
Forty seven eyes of 47 patients with nv-AMD (with CDVA LogMAR 0.7 or better) undergoing monthly intravitreal injections of ranibizumab were enrolled into this prospective study. Visual function was assessed using a range of psychophysical tests and by questionnaire, while mean foveal thickness (MFT) and mean foveal volume (MFV) were determined by optical coherence tomography (OCT), all at monthly intervals.
Group mean (±sd) MFT reduced significantly from baseline (233 [±59]) to exit (205 [±40]) (p=0.001). Visual acuity and questionnaire scores exhibited no change between baseline and exit visits (p=0.48 and p=0.31 respectively). Measures of visual function that did exhibit statistically significant improvements (p<0.05 for all) included: mean reading speed, mesopic contrast sensitivity (CS) at low and high spatial frequencies, mesopic glare disability (GD) at low and medium spatial frequencies, and retinotopic ocular sensitivity (ROS) at all eccentricities.
Eyes with nv-AMD undergoing monthly intravitreal ranibizumab injections exhibit improvements in many parameters of visual function. It appears that CS under mesopic conditions at low and high spatial frequencies, mean reading speed, GD at low spatial frequencies and ROS would be more sensitive outcome measures than CDVA for patients undergoing this treatment, at least in eyes where baseline CDVA is logMAR 0.7 or better. Such outcome measures should be considered in the design of studies investigating nv-AMD.
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