Baseline characteristics and response to intravitreal ranibizumab therapy for age-related macular degeneration

Abstract

Purpose: To study the baseline characteristics and response to intravitreal ranibizumab (IVR) therapy for age-related macular degeneration (AMD).

Methods: We reviewed clinical records of 119 eyes in 118 AMD patients who underwent IVR 3 times for induction therapy, and additionally when fluid or visual loss was observed during a 12-month follow-up. Baseline characteristics were analyzed, and responders and non-responders were identified at month 12. Patients whose best corrected visual acuity (BCVA) worsened more than 0.2 in logMAR score were, and those with increased or new exudative fundus findings or an increased central retinal thickness more than 100 micrometers were, considered to be non-responders as judged by BCVA, and by fundus findings, respectively. Adjusted odds ratios (ORs) for responders and non-responders, and 95% confidence intervals (CIs) were estimated with logistic regression models.

Results: Non-responders represented 16.8% of the AMD patients, as judged by BCVA, and 21.0%, as judged by fundus findings. The average age of non-responders by BCVA was higher than responders. Fibrovascular pigment epithelial detachment (PED) (odds ratio 3.77, 95% CI 1.03- 13.83) and serous PED (odds ratio 4.86, 95% CI 1.17-20.11) at baseline were associated with non-response as judged by BCVA . Fibrovascular PED (OR 7.07, 95% CI 2.30-21.72), and type 1 choroidal neovascularization (OR 4.06, 95% CI 1.13-14.65) at baseline were associated with non-response, as judged by fundus findings.

Conclusions: Although most AMD patients responded to IVR therapy, non-responders had clinical characteristics at baseline that might be informative for managing their treatment.

Keywords: 412 age-related macular degeneration • 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • 748 vascular endothelial growth factor