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L. C. Castro, C. Baumal, R. Chen, J. S. Duker, E. Reichel, A. H. Rogers; Optical Coherence Tomography and Visual Acuity Results Correlated to the Initial Anatomic Response Following Intravitreal Injection of Ranibizumab in Wet Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2369.
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To evaluate the 12-month OCT and visual acuity data in patients with wet AMD treated with intravitreal injection of ranibizumab, grouped according to the initial anatomic response as determined by OCT.
A retrospective review of the charts of 34 eyes of 34 patients enrolled in the SAILOR trial. Patients were randomized to treatment with 3 monthly intravitreal injections of either 0.3mg or 0.5mg of ranibizumab, and then retreated as determined by investigator. Visual acuity was measured with Early Treatment of Diabetic Retinopathy Study (ETDRS) eye charts, and OCT central subfield thickness (central 1000-µm diameter circle) measurements were obtained with Stratus OCT. Anatomic improvement was characterized in terms of absolute change in central subfield thickness and standardized change in macular thickening (SCMT). "Anatomical success" was defined as an OCT central subfield thickness ≤252 µm (mean for a normal population = 212 ± 20 µm).
Thirty-four patients were included in the analysis. Six patients had initial CRT ≤ 252 µm (Group 1), 18 patients had initial CRT > 252 µm and achieved "anatomical success" after 1 injection (Group 2), 4 patients had initial CRT > 252 µm and achieved "anatomical success" after 3 injections (Group 3), and 6 patients had initial CRT > 252 µm and didn’t achieve "anatomical success" after 3 injections (Group 4). At 12-months of follow-up, mean number of injections was similar between groups, the mean CRT decreased in all groups and was statistically significant smaller in Group 1 compared to the others groups, although this difference was not accompanied by similar VA improvement.
Patients with wet AMD and initial CRT inside the normal range have better anatomical results than patients with initial CRT outside the normal range when treated with intravitreal ranibizumab. Initial anatomic improvement does not correlate to visual acuity improvement in patients treated with ranibizumab.
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