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H. R. Chowdhury, S. Jyothi, V. Chong, S. Sivaprasad; Efficacy of Ranibizumab in Patients Previously Treated With Photodynamic Therapy (PDT) for Neovascular Age-Related Macular Degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 2009;50(13):1909.
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This observational case series assessed the outcome of intravitreal ranibizumab in eyes with persistent or re-activation of choroidal neovascularisation (CNV) following previous treatment with photodynamic therapy (PDT).
Baseline assessments include best-corrected visual acuity, fluorescein angiography (FFA) and optical coherent tomography (OCT). Intravitreal ranibizumab was administered monthly for 3 months and then as when necessary as guided by visual outcome and OCT. Follow-up period was 6 months.
Forty patients previous treated with PDT for neovascular AMD (mean 1.5 PDT sessions) showed re-activation or persistent CNV. Mean interval between PDT and intravitreal ranibizumab was 16 weeks (range 12 - 48 weeks). The mean deterioration of visual acuity following PDT was 13 ETDRS (55.9 to 43.1 letters). Following ranibizumab treatment, the mean visual acuity at first, third and sixth months were 46.3, 46.5 and 44 respectively. The proportion of patients with stable vision (loss of ≤15 letters) was 95% at 1 and 3 months and 98% at 6 months, while the proportion of patients that gained vision was 7.5%, 9.5% and 11.5% at 1st, 3rd and 6th month respectively. Central retinal thickness improved from 302µ at baseline to 258 µ at the end of 6th month. The average numbers of injections were 4.37 at 6 months. There were two cases of RPE rip following treatment with ranibizumab.
The visual outcome with intravitreal ranibizumab in patients previously treated with PDT was not as those reported in treatment naïve lesions.
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