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Lala Ceklic, Carsten Framme, Ute E. Schnurrbusch-Wolf, Sebastian Wolf; Three Year Results of Visual Outcome with Disease-Activity-Guided Ranibizumab Algorithm for the Treatment of Exudative Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2012;53(14):438.
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To evaluate three year follow up treatment outcomes with ranibizumab (Lucentis®) 0.5 mg administered either monthly or quarterly on a pro re nata (PRN) basis according to a disease-activity-guided monitoring and treatment algorithm.
A total of 316 treatment-naive eyes of 316 patients with exudative age-related macular degeneration met the criteria for inclusion in this retrospective, interventional case series. Patients were treated with ranibizumab 0.5 mg according to a disease-activity-guided algorithm with monthly monitoring following the standard loading phase with 3 injections. Spectral Optical coherence tomography was routinely used to assess disease activity by qualitatively judging subretinal fluid: active lesions showing subretinal fluid were treated with a series of 3 monthly injections, whereas inactive lesions (dry retinal conditions) were treated with quarterly injections.
Mean best-corrected ETDRS visual acuity improved from 52 letters at baseline to 59 letters at 12 months, achieved with a mean of 7.4 injections, 60 letters at 24 months with a mean of 12.1 injections administered up to the second year and again 60 letters at 36 months with a total mean number of 16 injections.
A morphology driven Pro re nata regimen with ranibizumab administered either monthly or quarterly in long term follow up (up to 36 months) resulted in BCVA gain of 8 letters which is in favorable correlation to the expected visual gain derived from the MARINA- and ANCHOR studies; however, using significant less injections.
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