Purchase this article with an account.
Takeya Kohno, Manabu Yamamoto, tasuku yoneda, Yusaku Yoshida, Hisashi Iwami, Mayumi Kaida, Michiko Hirabayashi, Kunihiko Shiraki; Visual acuity loss at a two-year follow-up in patients with exudative age-related macular degeneration treated with ranibizumab and as needed retreatment basis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3795.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the characteristics of eyes with visual acuity (VA) loss at a two-year follow-up in patients with exudative age-related macular degeneration (AMD) initially treated with intravitreous injections of ranibizumab (IVR) and retreated as needed.
This is a retrospective case series study of a two-year follow-up. Among 66 eyes started with three monthly IVR, 25 eyes with the VA less than 0.7 had been scheduled to have a combined therapy with half-fluence photodynamic therapy, but patients preferred IVR monotherapy. The rest of the 41 eyes with the initial VA better than or equal to 0.7 had IVR monotherapy as scheduled. The 66 eyes consisted of 32 eyes with typical AMD, 31 eyes with polypoidal choroidal vasculopathy (PCV), 3 eyes with choroidal neovascularization (CNV) with chorioretial anastomosis (type 3 CNV). Retreatment was done as needed. A change of 0.3 or more in the logMAR VA units was considered significant.
The number of patients with decreased VA was 3 eyes out of 66 eyes at month 3 (3M), 1 eyes at 6M, 4 eyes at 12M and 8 eyes at 24M. The mean VA of the 8 eyes was 0.21 at pre-treatment, 0.28 at 3M (p=0.273), 0.31 at 6M (p=0.068), 0.49 at 12M (P=0.028) and 0.79 at 24M (P=0.012). The mean central foveal thickness (CFT) decreased from 322.9 µm at pre-treatment to 253.5 µm at 3M (p=0.263), then back to 329.3 µm at 24M (p=0.484). The mean total IVR was 12.5. Cystoid lesions were found in 7 eyes of the macula. In the remaining 58 eyes, the mean VA was 0.18 at pre-treatment, 0.12 at 3M (P<0.001), and remained up to 24M (0.10, p<0.001). The mean CFT was decreased from 301.1 µm at pre-treatment to 192.1 µm at 3M (p<0.001) and 200.6 µm at 24M (p<0.001). The mean total IVR was 7.9. Cystoid lesions were found in 19 eyes. Significant difference was found between these two groups in age (p=0.033), in AMD type (PCV (p=0.037) and type 3 CNV (p=0.003)), in VA at 12M (p=0.002) up to 24M (p<0.001), in CFT at 3M (p=0.045) up to 24M (p<0.001), in the total IVR number (p<0.001) and in the presence of cystoid lesions (p=0.003).
The number of patients losing VA increased, especially after 12M. The CFT at 3M and the cystoid lesions may be associated with the long-term visual loss.
This PDF is available to Subscribers Only