Abstract
Purpose: :
To assess efficacy of as needed (pro re nata, PRN) dosing of Ranibizumab versus monthly dosing of Ranibizumab for patients with wet age-related macular degeneration (AMD).
Methods: :
A randomized, controlled clinical single-center trial comparing the efficacy of monthly versus PRN dosing of Ranibizumab (0.5 mg or 2.0 mg) for patients with wet AMD. High-resolution optical coherence tomography (HR-OCT) studies were used to guide PRN treatment and any cystic spaces or subretinal fluid prompted retreatment.
Results: :
At 12 months, patients receiving PRN Ranibizumab had a mean increase in VA of 7.9 Early Treatment Diabetic Retinopathy Study (ETDRS) letters ± 1.1 standard error and a reduction of central macular thickness on HR-OCT of 58.3 microns ± 8.7 standard error (n = 40). Patients receiving monthly Ranibizumab had a mean increase in VA of 5.2 ETDRS letters ± 3.1 standard error and a reduction of central macular thickness on HR-OCT of 88.1 microns ± 19.4 standard error (n=30). Macular function assessed with multifocal ERG testing and microperimetry improved comparably in both the PRN and monthly groups.
Conclusions: :
PRN dosing of Ranibizumab guided by HR-OCT appeared to maintain vision and improve macular function, but monthly dosing elicited a greater mean reduction in central macular thickness in wet AMD patients.
Clinical Trial: :
http://www.clinicaltrials.gov NCT00764738
Keywords: age-related macular degeneration