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Rosa Dolz-Marco, Roberto Gallego-Pinazo, Diamar Pardo, Cristina Marin-Lambies, Ester Frances, Antonio Lleo, J. Fernando Arevalo, Manuel Diaz-Llopis; Adult Onset Foveomacular Vitelliform Dystrophy and Ranibizumab. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5013.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of intravitreal injections of ranibizumab in adult onset foveomacular vitelliform dystrophy (AOFVD)
Seven eyes of six patients with visual impairment due to AOFVD were recruited (mean age: 80.5 years; 2 males and 4 females). Baseline examination included: logMAR best corrected visual acuity (BCVA), spectral-domain optical coherence tomography (automated central subfield thickness -CST- measurement and manual segmentation between the subretinal deposit and the overlying neurosensory retina measures; vitreo-macular interface assessment), fluorescein and indocyanine green angiography, electrophysiological tests (electroretinogram and electrooculogram), and an exhaustive familial history of macular diseases. Cases were treated with an initial intravitreal injection of ranibizumab and thereafter scheduled into a quarterly follow-up. Further retreatments were performed in case of persistence or recurrence of metamorphopsia, or visual acuity decrease.
The mean follow-up period was 43.7 weeks [range: 28-61]. The mean BCVA improved from 0.45 logMAR [range: 0.2-0.7] at baseline to 0.29 logMAR [range: 0.1-0.7] at the last follow-up visit (p=0,0065); however, the mean central subfield thickness (335.0 from baseline to 304.3 microns, p=0,0114), the subretinal deposit thickness (239.4 from baseline to 245.2 microns, p=0,7094), and the overlying neurosensory retina thickness (101.8 from baseline to 97.1 microns, p=0,7984) did not change significantly. The only vitreo-macular abnormality evidenced was a posterior vitreous detachment with a mild epimacular membrane in one case. The mean number of intravitreal injections of ranibizumab administered was 2.1 [range: 1-3]. Three eyes (43.9%) required only 1 treatment through the follow-up period, whereas four eyes (57.1%) required 3 treatments due to recurrence of metamorphopsia. In one case disappearance of the subretinal deposit with secondary retinal atrophy was noticed following intravitreal ranibizumab, with transient decrease in BCVA which improved spontaneously later.
Intravitreal injections of ranibizumab may be effective in improving visual acuity and metamorphopsia in patients with AOFVD, showing no significant changes in the optical coherence tomography quantitative parameters. Further studies are warranted to confirm these data.
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