Ranibizumab for vascularized pigment epithelium detachment in neovascular age-related macular degeneration: a retrospective analysis from the 12-month real-world TWIN study

Abstract

Purpose: The evidence on response to anti-vascular endothelial growth factor treatment for vascularized pigment epithelium detachment (PED) in neovascular age-related macular degeneration (nAMD) is lacking in clinical as well as real-world setting. This post-hoc analysis of a retrospective, observational study (TWIN) aims at describing the effectiveness of ranibizumab in nAMD patients with PED.

Methods: TWIN was a French multicenter, observational, retrospective chart-review study of data acquired after 12 months of ranibizumab treatment in nAMD patients. Medical records of 881 nAMD patients were reviewed retrospectively; 30% (N=265) patients were reported with vascularized PED (“PED”) and 70% (N=616) with no PED (“No PED”) at baseline. Patients were treated with ranibizumab as per the physician decision. Descriptive measures included change in best-corrected visual acuity (BCVA; early treatment diabetic retinopathy study [ETDRS] letters) and number of ranibizumab injections over 12 months, in all patients and those who completed loading phase.

Results: At baseline, patients had a mean (±standard deviation [SD]) age of 79.3±7.8 years<br /> (“PED”: 78.8±7.8; “No PED”: 79.6±7.8 years; p=0.172); 67.6% patients were female, and 61.3% patients had occult choroidal neovascularization. The mean (±SD) VA at baseline was 57.0±17.7 (“PED”: 58.2±18.3; “No PED”: 56.5±17.4 ETDRS letters, p=0.228). At Month 12, the mean (±SD) change in VA in patients with PED and those with “No PED” was 3.8±15.7 and 4.4±15.3 ETDRS letters (p=0.601), respectively. Patients with PED and “No PED”, received a mean (±SD) of 6.0±2.3 and 5.4±2.2 injections (p< 0.001), respectively. Similarly, patients with PED and “No PED” who completed loading phase had a mean (±SD) change in VA of 5.1±16.0 and 4.7±15.2 ETDRS letters (p=0.782), and received a mean (±SD) of 6.7±2.4 and 5.7±2.2 injections (p<0.001), respectively over 12 months.

Conclusions: This retrospective analysis from the TWIN study in nAMD showed clinically meaningful vision gains with ranibizumab regardless of baseline PED status in a “real-word” setting. This suggests that nAMD patients with PED are managed effectively with ranibizumab in routine clinical practice.