Purchase this article with an account.
Jeffrey Chang, Jeffrey S. Heier; Double-dose Ranibizumab For Choroidal Neovascularization Associated With Age-related Macular Degeneration Minimally Responsive To Prior Anti-Vascular Endothelial Growth Factor Treatment. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3543.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of high dose (1 mg) injections of intravitreal ranibizumab (Lucentis) for choroidal neovascularization (CNV) in age-related macular degeneration (AMD) minimally responsive to prior ranibizumab or bevacizumab treatments.
A retrospective, non-randomized, interventional case series was conducted in 29 eyes of 29 patients with subfoveal CNV associated with AMD between December 2009 and October 2010. All patients received injections of high dose ranibizumab (1.0 mg in 1.0 mL) after minimally responding to multiple previous ranibizumab (0.5 mg in 0.5 mL) and/or bevacizumab treatments. The need for re-treatment was physician-dependent and determined after clinical assessment and was based upon best corrected visual acuity (BCVA) and central foveal thickness (CFT) as determined by optical coherence tomography (OCT).
Twenty nine eyes received an average of 2.7 injections of high dose intravitreal ranibizumab. Average initial CFT and BCVA was 387 microns and 20/74 (logMAR=0.57), respectively. Post-treatment mean CFT and BCVA was 344 microns and 20/75 (logMAR= 0.57), respectively, with a minimum one month follow-up. No adverse events were noted.
Patients recalcitrant to multiple prior ranibizumab and/or bevacizumab treatments experienced an average improvement in CFT after an average of 2.7 injections of high dose ranibizumab at monthly intervals. The average BCVA remained stable. These findings suggest that there may be a subset of patients minimally responsive to prior treatment that may benefit from high dose ranibizumab. Greater numbers of patients and longer follow-up are required to confirm these results.
This PDF is available to Subscribers Only