Abstract
Purpose: :
Intravitreal application of Ranibizumab is an effective therapy for exsudative age-related macular degeneration. However, treatment is highly expensive and needs extraordinary manpower as well as frequent controls to effectively use the high potential of Ranibizumab. Aim of the study was to find out the optimal interval between diagnosis and first upload injection.
Methods: :
All patients treated with Ranibizumab since February 2007 have been reviewed. Best corrected visual acuity using Snellen charts was evaluated at the time at diagnosing exsudative AMD, at each injection and six weeks after the third injection. Time intervals of less than two weeks, two to three weeks and more than three weeks were defined and patients were allocated to the appropriate group according only to their waiting time. Data were evaluated using Student’s t-test, and p<0.05 was selected to reflect significance. Best corrected visual acuity was the only outcome parameter. There were no statistically significant differences at baseline visit (diagnosis of exsudative AMD) regarding age, gender or initial visual acuity.
Results: :
684 eyes (421 female, 263 male) were evaluated. Mean patient age was 77.3 years over all patients. Best corrected visual acuity improved statistically significant during the upload phase by about 1.2 lines and remained stable until control visit six weeks after the third upload injection. The loss of visual acuity from diagnosing exsudative AMD to the first injection depends on the time interval. About 0.7 lines are lost when the patient has to wait more than 3 weeks, about 0.3 lines loss occur when waiting 2-3 weeks but nearly no vision loss (0.1 lines) takes place when starting to treat earlier than 2 weeks after diagnosing.
Keywords: age-related macular degeneration