An Optical Coherence Tomography Guided Loading Dose Treatment With Intravitreal Ranibizumab for Neovascular Age Related Macular Degeneration

Abstract

Purpose: : To evaluate the efficacy of intravitreal ranibizumab using Optical Coherence Tomography (OCT) guided loading dose regime in neovascular age related macular degeneration (AMD)

Methods: : Retrospective review of 100 eyes of 100 consecutive patients was done. All lesion subtypes resulting from neovascular Age related macular degeneration were treated with intravitreal Ranibizumab and followed up for a period of 6 months. Treatment consisted of pars plana injection of 0.5 mg of Ranibizumab in 0.05ml. Treated eyes received series of three consecutive loading injections at intervals of four weeks followed by treatment if necessary ( PRN Pro re nata ) according to the re-treatment criteria. The re-treatment criteria were presence of sub retinal fluid, new haemorrhage and increase in central macular thickness ( CMT) compared to the previous visit. Evaluation consisted of complete ophthalmic examination, including Early Treatment Diabetic Retinopathy Study best corrected visual acuity (VA) measurement, Ophthalmoscopy and OCT at baseline and follow-up visits.

Results: : The mean age was 80.4 years. At the 6 month follow-up the mean visual acuity improved by 1.32 letters (p=0.04) and the mean central macular thickness decreased by 35.73 microns (p<0.01). Visual acuity improved 10 or more letters in 31% of patients. These were achieved with an average of 4.5 injections over 6 months

Keywords: macula/fovea • age-related macular degeneration • choroid: neovascularization