Abstract
Purpose: :
This prospective pilot study documents the effects of monthly optical coherence tomography (OCT)-guided ranibizumab over one year in patients with uveitic cystoid macular edema (UCME) and otherwise quiet noninfectious uveitis.
Methods: :
Five eyes in 5 patients with controlled noninfectious uveitis and UCME were enrolled in a prospective pilot study of monthly ranibizumab (0.5mg) intravitreal injections. Injections were repeated monthly over 12 months if there was an increase in or persistence of retinal thickening or cysts. In addition to each monthly visit, patients were examined one week following each injection.
Results: :
All 5 patients finished 12 months of follow-up. Mean early treatment diabetic retinopathy study letters gained was 12 letters (p=0.02) between the entry and final visits. At 12 months mean reduction in central retinal thickness was 45% (p=0.006). The mean number of injections given was 6.4 injections over 12 months. The mean number of injections was 4.6 injections in the first 6 months of the study and 1.8 in the second six months (p=0.0086). Adverse events included subconjunctival hemorrhage, post-injection discomfort, and in one patient, recurrence of anterior uveitis two weeks following injection, with progression of cataract and glaucoma.
Conclusions: :
OCT-guided monthly ranibizumab led to improved visual acuity and decreased retinal thickness. Frequent injections were required and were well tolerated. The number of injections required was significantly less in the second six month period than in the first.
Clinical Trial: :
http://www.clinicaltrials.gov NCT00826618
Keywords: uveitis-clinical/animal model • macula/fovea • drug toxicity/drug effects