Predictive Factors for Visual Acuity “Gain and Maintain” after Ranibizumab Treatment for Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy

Abstract

Purpose: To investigate the predictive factors for each visual acuity responder type at one year after intravitreal injections of ranibizumab (IVR) for age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV) and retinal angiomatous proliferation (RAP) in Japanese patients.

Methods: Three hundred and thirty-seven eyes undergoing IVR treatment (AMD 183 eyes; PCV 141 eyes; RAP 13 eyes) were retrospectively studied. “Gain”was defined as best-corrected visual acuity (BCVA) increase in the study eye from baseline to month 3 and “maintain” was defined as a loss of no more than 0.1 log MAR in mean BCVA of the study eye at month 12 compared to month 3. “No initial gain”was defined as no initial gain and no gain during the PRN phase. Each responder type outcomes at one year after treatment were analyzed based on the following: age, sex, VA, type of disease, greatest linear dimension (GLD), central retinal thickness, injection numbers, hypertension, diabetes, and smoking habits.

Results: The “gain and maintain” group consisted of 140 eyes (42%). The BCVA increased steadily with the 3 initial doses and was maintained throughout the PRN phase with an average of 1.86 re-treatments. The “gain but not maintained” group consisted of 80 eyes (24%) with 1.85 additional retreatments. In the “no initial gain” group, 117eyes (34%) showed no initial gain and no gain during the PRN phase. Multivariate logistic regression analysis found the independent predictor for “gain and maintain” to be GLD (P=0.0006).

Conclusions: IVR is well tolerated in eyes of Japanese patients with AMD and PCV. Smaller GLD at baseline may be a good prognostic factor for VA “gain and maintain” after IVR.

Keywords: 412 age-related macular degeneration • 748 vascular endothelial growth factor • 453 choroid: neovascularization