Abstract
Purpose: :
To investigate predictive factors of efficacy of intravitreal ranibizumab in patients with choroidal neovascularisation (CNVM) secondary to age-related macular degeneration, as measured by changes in visual acuity (VA) and central macular thickness (CMT). In an attempt to identify if there was a role for screening patients in our centre, we tested the hypothesis that patients presenting with 2nd eye involvement have better response than those presenting with 1st eye involvement, due to early presentation and early treatment.
Methods: :
A retrospective study was conducted of patients treated with Ranibizumab for CNVM and followed up for 54 weeks (n=62). Patients were divided into 2 groups: '1st eye affected’ were those with no previous CNVM who presented for the 1st time (n=31); ‘2nd eye affected’ were those with previous CNVM in one eye who then presented with CNVM in the 2nd eye (n=31 ). VA was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) score and CMT using optical coherence tomography (OCT) at baseline and 54 weeks. .
Results: :
Mean change in VA (ETDRS letters) from baseline to 54 weeks was +7.52 for the 1st eye and +7.71 for the 2nd eye group. There was no significant difference between groups (p=0.153). Mean change in CMT was - 31.5 µm for 1st eye and -56.28µm for the 2nd eye group. There was no significant difference between groups (p=0.880). 91.5% of the 1st and 96.2% of 2nd eye groups maintained/improved their vision at 54 weeks. 41.93% of the 1st and 22.58% of the 2nd eye groups improved their vision (gained more than or equal to 15 letters). Given the trend for 1st eye patients to have lower baseline VA and to achieve better VA change at 54 weeks, correlation between baseline VA and change in VA across all patients was tested and was significant (p<0.01).
Conclusions: :
The study did not support the hypothesis that patients presenting with 2nd eye affected by CNVM would achieve better VA or CMT change at 54 weeks post initiation of Ranibizumab therapy. The results in fact showed that, at 54 weeks, there was a significantly greater percentage of 1st eye patients whose VA improved (gained greater than or equal to 15 letters) than 2nd eye patients (p=0.037).
Keywords: age-related macular degeneration • choroid: neovascularization • clinical (human) or epidemiologic studies: natural history