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Nadezhda Cvetkova, David Maerker, Horst Helbig, Kristina Hoelldobler; Ranibizumab (Lucentis) in neovascular age- related macular degeneration (AMD): five year follow up. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3951.
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Ranibizumab is a generally approved anti- vascular endothelial growth factor (anti- VEGF) used for treating neovascular age-related macular degeneration (AMD). Our aim was to evaluate an optical coherence tomography and visual acuity guided, variable-dosing regimen with intravitreal Ranibizumab injection for the treatment of patients with AMD from 2007 till 2012.
In this study 69 patients with neovascular AMD (mean 74 years) were included. We investigated the development of best- corrected visual acuity (BCVA), the number of intavitreal injections and the central retinal thickness measured with optical coherence tomography (OCT Spectralis, Heidelberg Instruments) over five years of treatment.
Mean number of itravitreal injections over five years was 8.8. Mean BCVA before intravitreal therapy was 0.4 log MAR. After five years of therapy mean BCVA was 0,6 log MAR. 24 % of treated patients had stable visual acuity over five years of intravitreal therapy, 10 % of study eyes approved their visual acuity. In 66 % of study eyes we detected loss of visual acuity. Mean OCT measured central retinal thickness at the beginning of this study was 268µm, after five years of treatment mean central retinal thickness was 293µm. There was no statistically significant difference between central retinal thickness measured by OCT at the beginning and after five years of therapy. In 41% of study eyes central retinal thickness decreased after intravitreal therapy. There was an increase in central retinal thickness in 57% of examined eyes. In 2% of study eyes was no detectable change in the central retinal thickness after therapy.
Our study revealed a loss of visual acuity and increase of central retinal thickness in five years follow up of patients with neovascular AMD. Probably these are results of a deficient treatment of AMD patients, as sometimes especially elderly patients were not able to travel long distance in frequent times for regular visites in our clinic. Another possibility is the disease itself, which is chronic and progressive. Furthermore many patients suffered from later stages of AMD (initial BCVA 0,4 log MAR). Anti-VEGF Therapy helps to keep the visual acuity for a term of time stable, but cannot stop the progress of the disease.
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