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Yusaku Yoshida, Takeya Kohno, Manabu Yamamoto, Yuta Sawa, Kumiko Yoshimoto, Mariko Yoneda, Kunihiko Shiraki; Aggravation Of Neovascular Age-related Macular Degeneration During The Induction Period Of Intravitreal Ranibizmab. Invest. Ophthalmol. Vis. Sci. 2012;53(14):865.
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To investigate aggravations seen during the induction period of intravitreal ranibizmab (IVR) therapy for patients with neovascular age-related macular degeneration (AMD).
84 of 83 AMD patients (65 male eyes and 19 female) ranging from 56 to 96 years (average, 72.6) of age had been treated by IVR monotherapy in the Department of Ophthalmology at Osaka City University between April 2009 and February 2011. During three monthly IVR injections, best-corrected visual acuity (BCVA) and optical coherence tomography were performed monthly, and fluorescein angiography/indocyanine green angiography (FA/IA), quarterly. Aggravation during the induction period was defined as worsening in BCVA, increase in serous retinal detachment (SRD), pigment epithelial detachment (PED), subretinal hemorrhage (SRH) or leakage on FA, expansion of polyp-like vascular dilatation and appearance of retinal pigment epithelial tear (RPE tear).
Aggravation was seen in 11 of the 84 eyes (13.1%) those were all occult type AMD including 5 eyes of polypoidal choroidal vasculopathy. Of the aggravated 11 eyes, 5 eyes showed VA loss. Increase in SRD. PED, SRH and leakage on FA was seen in 2 eyes at one month after the induction, 1 eye at one month, 2 eyes with one at one month and the other at 3 months and 1 eye at 3 months, respectively. RPE tear occurred in 1 eye at 1 month, and expansion of the polyp-like change was noted in 1 eye at 3 months.
There were relatively few aggravated eyes during IVR induction period. However, further studies are necessary to know whether IVR monotherapy should be combined with other treatments such as photodynamic therapy when these aggravations were noted during the induction period.
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