Abstract
Purpose:
To investigate the predictive factors for minimum number of ranibizumab injections 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:
Four hundred and forty-four eyes undergoing IVR treatment (AMD 276 eyes; PCV 158 eyes; RAP10 eyes) were retrospectively studied. All patients initially received three monthly IVR as induction phase and additional IVR was performed as needed (pro re nata [PRN]) in maintenance phase. “Minimum IVR treatment “ was defined as the patients received only three induction monthly injection and no additional injections in PRN phase. “More than four IVR” was defined as the patients received additional IVR during PRN phase. The outcomes at one year and predictive factors for minimum IVR treatment were analyzed based on the following: age, sex, VA, type of disease, FA classification, greatest linear dimension (GLD), central retinal thickness (CRT), hypertension, diabetes, and smoking habits.
Results:
One hundred fifty five eyes (35%) received only three induction IVR treatment and no additional injections for one year. The best-corrected visual acuity (BCVA) and CRT at one year after treatment were significantly improved compared to baseline in both “minimum IVR treatment” group and “more than four times IVR” group (P<0.0001). There was no significant difference in BCVA change and CMT change between these two groups (BCVA: P=0.75, CMT: P=0.84). Although the mean GLD of “Minimum IVR treatment” group is significantly smaller (3552μm) than “more than four times IVR” group (4281μm) (P=0.035), multivariate logistic regression analysis could not find the any independent predictor for “minimum IVR treatment”.
Conclusions:
There are some cases of Japanese wet AMD patients that only need initial induction IVR treatment, but predictive factors remain unclear. It is possible that a patient based personalized approach may be needed until there is additional evidence.
Keywords: 412 age-related macular degeneration •
688 retina •
453 choroid: neovascularization