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Hassiba Oubraham Mebroukine, Olivier Chevreaud, Farah Gherdaoui, Camille Jung, Eric H Souied; Anatomic and functional results of Vascularized Pigment Epithelial Detachment treatment with ranibizumab ( V-PED): One year follow-up of visual and anatomical outcomes. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5359.
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© ARVO (1962-2015); The Authors (2016-present)
The effect of the anti-vascular endothelial growth factor agent, ranibizumab, on V-PEDs needs to be defined as they have not been included in major phase III clinical trials. This study aims evaluating the effectiveness of ranibizumab in the V-PED treatment by assessing anatomical and functional outcomes after one-year treatment in wet age-related macular degeneration (wAMD) patients
Medical records of 2097 treatment-naïve wet AMD patients who have initiated treatment with ranibizumab between January 2011 and June 2013 were reviewed in Intercommunal Hospitalier of Creteil. Inclusion criteria were: Presence of V-PED with height > 250 µm, ranibizumab treatment with a loading phase (three monthly injections) followed by a Pro-Re-Nata regimen, and one-year follow-up. Baseline characteristics (type of choroidal neovascularization (CNV) and presence of polypoidal choroidal vasculopathy (PCV)) were analyzed. Height of the V-PED, the central macular thickness (CMT) and best-corrected visual acuity (BVCA, logMar) were analyzed at baseline, Month 3, Month 6 and Month 12. Compliance with the loading phase and number of intravitreal injection were also evaluated
A total of 103 patients were included (68 females) with a mean (±SD) age of 77.3±8.13 years. The CNV was occult in 80.6% of patients, predominantly classic in 4.8%, a retinal angiomatous proliferation in 5.8% and PCV in 8.8%. Mean (±SD) CMT at baseline was 573 µm (±209.84) and decreased significantly over one year follow-up (p<0.0001); [Month 3: 412 µm (± 174.55) Month 6: 412.95 µm (±175.47) and Month 12: 397.85 µm (± 170.11)]. Mean (±SD) height of PED was 457.61 µm (±186.33) at baseline and decreased significantly over one year follow-up (p<0.0001); [Month 3: 337.89 µm (±220.79); Month 6: 333.92 µm (±192.11) and Month 12: 308.34 µm (±180.02)] with an overall 33% decrease of mean V-PED height. Significant improvement in BVCA was also observed [Baseline: 0.45 (±0.34); Month 3: 0.39 (±0.28); Month 6: 333.92 µm (±192.11) and Month 12: 308.34 µm (±180.02)]. Mean (±SD) number of IVT was 6.83<br /> (± 2.25) and 93.1% of patients completed the loading phase.
The study indicates that treatment with ranibizumab improves visual and anatomical outcome in wAMD patients with V-DEP with a significant decrease of the height of DEP and a significant gain in VA.
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