Abstract
Purpose:
To study the effect of intravitreal Ranibizumab injections on Vitreomacular interface in patients with Age Related Wet Macular Degeneration(AMD)
Methods:
We retrospectively analysed medical records and Optical coherent tomography (OCT ) scans of 27 consecutive patients (27 eyes) diagnosed with exudative AMD and receiving intravitreal Ranibizumab. The treatment consisted of 3 consecutive injections of Ranibizumab 0.5mg/0.05ml and then treated if necessary, depending on the retreatment criterion. Best corrected visual acuity (BCVA) (ETDRS),Central macular thickness (CMT), size of Vitreomacular adhesion/ traction (VMA/VMT), number of injections given were recorded and analysed at 0,3,6 and 12 months.
Results:
The mean age at presentation was 80yrs. At the end of one year mean number of injections given were 6.8. Mean BCVA (ETDRS) letters at baseline was 57.88 and showed a statistically significant improvement at 12 months by 7.12 letters (p=0.044828).Visual acuity was improved or stabilized in 22 out of 27 eyes (81%) . Baseline CMT was 334.08 micron and showed a significant reduction by 60.99 micron (p=0.018003). Mean size of VMA/VMT at baseline was 1229 micron and 1062 micron after one year. Change in size of VMA/VMT was not statistically significant (p=0.54746).During the study period out of 27 eye only 3 had spontaneous resolution 1 ( David A et al ) of VMA/VMT.
Conclusions:
Although few cases of spontaneous resolution of VMT after Ranibizumab injection have been reported in literature2,3 (Rouvas A et al 2008, 2013) , our results with small number of patients concluded that there was no significant change in vitreomacular interface before or after getting Ranibizumab.<br /> Further prospective studies with larger group of patients receiving different kinds of anti-vascular endothelial growth factor (anti-VEGF) injections are needed to fully evaluate the effect of different kind of anti-VEGFs on Vitreomacular interface.