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H. Zeghidi, H. Khlif, O. Megret, C. Peyre; Comparison of Intravitreal Ranibizumab in Classic vs Occult Neovascularization Secondary to Exudative Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2009;50(13):734.
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In exudative age related macular degeneration (AMD), classic and occult neovascularization are two different forms, by their clinical onset and progression in time. However intravitreal ranibizumab therapeutic scheme does not differ according to the type of neovascularization.The aim of our study was to compare the efficacy of intravitreal ranibizumab in two groups of patients with classic or occult choroidal neovascularization (CNV) secondary to AMD.
Retrospective comparative study of 23 eyes (23 patients). All patients had complete clinical examination, fluorescein and ICG angiography, and optical coherence tomography (OCT) before treatment. Only patients with classic (group 1) or occult (group 2) CNV were included in the study. Patient with predominantly classic or minimally classic CNV were excluded. All patients were treated with three monthly intravitreal injections of ranibizumab (0.5 mg). Patients were followed monthly with ETDRS visual acuity measurement, eye exam and OCT. Mean follow up was 7.65 months.(6-16)
Mean age of patients was 78 (range 64-90). Mean improvement of VA was 8.35 letters (5-28). In group 1 mean VA improvement was 7.7 letters, while it was 9.1 in group 2. This difference was not statistically significant (p=0.545). Frequency of first recurrences was 52.2% occurring between the 1st and the 5th month following the 3rd injection. Recurrences were statistically (p=0.039) more common in group 1 (75%) than group 2 (27.3%).
Intravitreal ranibizumab treatment was associated with more recurrences in classic than occult CNV. The type of neovascularization appears to be an important predictor factor of early recurrences, and should be considered in the treatment of exudative AMD
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