Abstract
Purpose: :
The aim of the present study was to investigate the effects on near visual acuity, reading speed, central visual field and related quality of life of ranibizumab treatment.
Methods: :
Thirty eyes of 30 patients with wet AMD were included in the present prospective, non-comparative consecutive case series, followed for three months. The study was investigator driven. Mean age was 75.2 years (range 69-95 years). All patients were eligible for and received ranibizumab treatment in our routine clinical program for wet AMD, where BCVA is used as the main outcome measure. They were subjected to a full ophthalmological examination including fluorescein and indocyanine green angiography (occult cases) and optical coherence tomography. Near visual acuity, reading speed, central visual field and quality of life for related activities were investigated at baseline and at three months as supplementary outcome measures. Therefore, this study was not regarded as a regular clinical trial of ranibizumab.
Results: :
Great improvements were found, in particular for reading speed and other vision related near activities. Mean BCVA increased from 62.1±10.5 to 66.3±14.0 letters at three months (+4.2 letters; 6.8%; p=0.018). Near vision improved from 9.2±5.0 to 6.3±3.1 points (+2.9 points; 31.5%; p=0.00056) and reading speed increased from 58.7±40.3 to 84.8±50.2 words/min (+26.1 words/min; 44.5%; p<0.0001). The mean deviation from normal of the visual field improved from -9.3±6.8 to -6.4±4.9 dB (+2.9 dB; 31.2%; p<0.0001). Quality of life improved for distance activities from 54.4±28.4 to 62.8±28.4 (+8.4 points; 15.5%; p<0.0001) but significantly (p=0.024) more for near activities, from 48.6±26.3 to 62.8±26.3 (+14.2 points; 29.2%; p=0.0001). The greatest improvement in quality of life was seen for reading newspaper for the group in which the better eye was treated (114.4%).
Conclusions: :
BCVA is only one aspect of vision. The present study showed significant improvements for near visual acuity, reading speed, central visual field and several activities influencing quality of life. The improvement was greater for near activities than for distance activities and greater when the better eye was treated than when the worse eye was treated. Thus, the beneficial effects of ranibizumab treatment shown here are even more prominent than reported earlier.
Keywords: age-related macular degeneration • choroid: neovascularization • clinical (human) or epidemiologic studies: outcomes/complications