Abstract
Purpose:
Intravitreal therapies directed against vascular endothelial growth factor (VEGF) have dramatically improved the visual prognosis of choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Debate exists regarding the best treatment and monitoring regimen for patients treated with intravitreal ranibizumab. <br /> A clinical study was conducted to evaluate the efficacy and safety of bimonthly pro-re-nata (PRN) intravitreal ranibizumab for the treatment of CNV secondary to AMD.
Methods:
Thirty patients affected by CNV due to AMD received an intravitreal ranibizumab injection at baseline then PRN. Patients were scheduled for bimonthly follow-up visit examinations. Unscheduled visits and rescue injections were allowed at investigator’s discretion or based on patient-reported outcomes. As-needed and rescue treatments were performed over a 12-month follow-up period on the basis of functional or morphological criteria. The primary outcome was the average best-corrected visual acuity change at one year. Secondary outcomes were central retinal thickness changes, number of injections, number of rescue visits and treatments. Safety data were recorded.
Results:
The study included 30 eyes with CNV secondary to AMD. At 12 months mean (±SD) visual acuity improvement was -0.13 (±0.23) logMAR (p<0.001) and macular thickness decreased on average by -102 (±151) µm (p<0.0001). Twenty-three percent of patients underwent a rescue visit and 13% of eyes required rescue treatment. The majority of rescue evaluations were performed at physician’s discretion. Patients received a mean of 4 injections. No significant adverse event was observed during the follow-up.
Conclusions:
Pro-re-nata ranibizumab administration with bimonthly evaluations produced significant functional and morphological improvements and may be a valide choice to reduce the burden of monitoring visits and injections.