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M.-H. Nghiem-Buffet, L. Dubois, T. Ramin, F. Fajnkuchen, C. Delahaye-Mazza, B. Guiberteau, G. Quentel, S. Y. Cohen; One-Year Results of Ranibizumab for Exudative AMD in a Clinical Setting. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2377.
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To analyze the one-year results of ranibizumab in patients with subfoveal exudative AMD in a tertiary care center established in Western Europe, to compare these results with the pivotal studies (MARINA and ANCHOR), and to search factors of favorable outcome.
Retrospective analysis of 122 consecutive patients (124 eyes) treated with intravitreal ranibizumab injections. None of these 124 eyes had undergone previous treatment. Change in visual acuity (VA) between baseline and week 52 +/- 6 was analyzed in regard to: age, gender, treated eye, subtype of choroidal neovascularization (classic vs occult), initial protocol (one or 3 initial injections, followed by re-injections decided as needed, based on OCT and VA findings).
At 52 weeks, mean VA remained stable (+0.7 letters), changing from 56.15 (+/-14) to 56.89 (+/-17) letters on ETDRS chart comparing with a mean improvement of +7.2 letters (MARINA) and 11.3 letters (ANCHOR). 90.3 % of the eyes lost fewer than 15 letters as compared with 94.6% (MARINA) and 96.4% (ANCHOR). Visual acuity improved by 15 or more letters in 8% of the eyes as compared with 33.8% (MARINA) and 40.3% (ANCHOR). At last follow-up, VA was 20/40 or more in 25.8% of the eyes as compared with 40% (MARINA) and 40.3% (ANCHOR). Age, gender, treated eye, type of CNV and protocol of initial management did not have an influence on final results.The mean number of injections per eye was 3.79 and the mean number of visits was 8.06 as compared with the 12 visits and injections in pivotal studies.
In the present study, mean number of injections was significantly smaller than in pivotal studies. But the results compare unfavorably with these studies. This difference could be explained by inclusion of patients with a VA out of the 20/320-20/50 range and, mostly, by a follow-up which appeared to be far less tight than in pivotal studies.The present study suggests that a closer follow-up of patients treated by ranibizumab is necessary to obtain and keep significant visual improvement, as shown in pivotal studies.
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