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Salomon Cohen, Bertrand Maloberti, Franck Fajnkuchen, Sylvia Nghiem-Buffet, Corinne Delahaye-Mazza, Typhaine Grenet, Gabriel Quentel; Bimonthly Ranibizumab for Exudative Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3808.
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To evaluate the results of bimonthly intravitreal ranibizumab for exudative age-related macular degeneration.
Retrospective, monocentric, non-controlled study of AMD patients with naive exudative AMD treated according to the following protocol: - Monthly intravitreal ranibizumab during a 3-month loading phase - Examination every 4 weeks during 52 weeks, including best-corrected ETDRS Visual acuity (BCVA), spectral-domain Optical Coherence Tomography, and fundus photography. Fluorescein angiography was performed at baseline, 24 and 52 weeks. - Scheduled bimonthly intravitreal ranibizumab. Non-scheduled rescue intravitreal ranibizumab was possible in case of VA loss of 5 letters or more, new hemorrhage, and/or significant exudation. Baseline recorded data was: age and gender of patients, side of study eye, type of choroidal neovascularization (CNV), classified in type 1, 2 or 3. Primary end points were: proportion of patients maintaining vision (i.e. losing < 15 letters), and change in BCVA. Other end points were: proportion of patients gaining ≥ 15 letters, change in central retinal thickness, number of intravitreal injections performed.
Thirty patients were included. Three patients did not complete the study, because of inability to consult each 4 weeks (one case), or non-related health problems (2 cases). Twenty-seven patients, 24 women and 3 men, aged from 68 to 90 years (mean: 81.2) were analyzed. At baseline, CNV subtypes were type 1 (n = 8), 2 (n = 7), 3 (n = 12). Twenty-five eyes (92.5%) lost < 15 letters. Two patients lost 26 and 28 letters, respectively because of RPE tear and subfoveal fibrosis. Mean BCVA changed from 58.3 (± 12.9) to 66.8 (± 14.3) letters. The mean visual gain was 8.40 ± 13.2 letters. Eleven patients (40.7%) gained ≥ 15 letters. Mean number of intravitreal injections was 8.77. More precisely, 19 patients received the 8 scheduled injections. Their mean visual gain was 11.7 letters. Eight patients required one to 5 non-scheduled injections. Their mean visual gain was limited to 0.75 letters.
Bimonthly ranibizumab after 3 initial monthly doses achieved satisfactory visual results, with a mean VA gain of 8.40 letters. However, patients who required additional injections did not have a significant visual gain.
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