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Angela L. Rees, Simona Degli Esposti, Oliver Comyn, Adnan Tufail, Praveen J. Patel; Long-term Structural and Functional Outcomes of Ranibizumab Therapy for Neovascular Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4400.
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To report long-term visual acuity (VA) and spectral domain optical coherence tomography (SDOCT) morphology outcomes in a cohort of patients with neovascular age-related macular degeneration undergoing ranibizumab therapy
A retrospective review of outcomes of therapy in consecutively treated eyes of patients with 24 months follow-up. Patients were treated with 3 loading dose injections with further treatment based on signals of disease activity. SDOCT images were read by experienced ophthalmologists with an assessment of abnormalities of retinal morphology at baseline, after 3 injections, after 12 and 24 months follow-up. VA outcomes were also recorded at these time points.
Of the 70 eyes of 70 consecutively treated patients identified with 24 months follow-up, 20% of patients gained 15 ETDRS letters or more after 3 injections, 31.4% after 12 months and 51.4% after 24 months. The proportion of patients who lost less than 15 letters of VA from baseline was 97.1% after 3 injections; 88.6% after 12 months and 88.6% after 24 months. The mean gain (+ SD) in VA from baseline was +6.2 + 10.9 ETDRS letters after 3 injections, +6.9 + 17.6 letters at 12 months and +11.2 + 20.1 letters at 24 months. Macular fluid was present on SDOCT in 93% of eyes at baseline, 66% after 3 injections, 69% at 12 months and 59% at 24 months.
Ranibizumab therapy can lead to sustained improvements in visual acuity and OCT based macular morphology at 2 years in a "real-world" clinical cohort of patients with nAMD. Macular fluid persisted in over half of the cohort suggesting persistent or recurrent disease activity and the need for ongoing therapy.
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