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Christoph Roman Clemens, Florian Alten, Armin Wolf, Caroline Milojcic, Nicole Eter; Monthly treatment of ranibizumab in vascular pigment epithelium detachment due to age-related macular degeneration . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2838.
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To assess the effects of monthly intravitreal ranibizumab injections in patients with vascularized pigment epithelial detachment (vPED) secondary to age-related macular degeneration (AMD).
A total of 40 patients were prospectively analyzed and treated monthly with 0.5mg ranibizumab injections (ClinicalTrials.gov Ident. NCT00976222). Best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) were evaluated at all visits. Fluorescein angiography and indocyanin green angiography were performed at baseline and quarterly. The change in BCVA, PED greatest linear diameter (GLD) and PED height from baseline to month 12 was determined.
Data on 20 patients were available. There were two types of PED, including serous vascular PED in 14 patients (group A) and fibrovascular PED in 6 patients (group B). Mean BCVA showed a deterioration between baseline and 12-month follow-up visit of 0.23 logMAR in group A and an improvement of 0.13 logMAR in group B. The mean decrease in PED height was 705,4μm in group A and 180,6µm in group B. Mean PED GLD increased from 3126,2 μm at baseline to 3564,6 μm at 1-year follow-up (P < 0.001). After a mean of 3.8 treatments, 9 patients of group A developed a retinal pigment epithelium (RPE) tear during the course of the treatment. No tear was documented in group B.
Ranibizumab is an effective treatment for vPED due to AMD regarding BCVA and morphologic characteristics of vPED lesions. Considering the relatively high rate of RPE tears serous vascular PED patients should be screened for the presence of morphologic risk factors for RPE tear development. An adapted treatment regimen in such patients presumably makes ranibizumab therapy safer.
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