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B. Vusirkala, C. Blyth, S. Banerjee; Our 2 Year Experience in Managing Wet AMD in Wales - Can We Predict Outcome?. Invest. Ophthalmol. Vis. Sci. 2010;51(13):73.
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To determine the visual outcomes for wet AMD treatment withintravitreal Ranibizumab at 24 months and to predict longtermtreatment outcomes
All patients received initial 3 loading dosesof Ranibizumaband subsequent injections were based on VA and OCT findings.Datawas collected prospectively as part of service audit. Visualimprovement and change in central retinal thickness(CRT)wasplotted on scatter diagram at 3 months and compared with thesame data at 12,18,24 months. Patients were categorised intoResponders- improvement in VA and CRT Partial responders- improvementin VA only, Structural damage- improvement in CRT only, Non-responders-no improvement in VA or CRT
Of the 232 patients 126 completed 18 months and 86 completed24 months followup. At12 months the mean VA improved by 5 lettersand at 24 months by 4 letters.The proportion losing less than15 letters at 12 months is 93% and at 24 months is 91.5 % .Theproportion gaining more than 15 letters is 22% at 12 monthsand 19.5% at 24months.The scatter plot shows that patients canchange from partial responders to responders. No patient inthe non responder or structural dammage group at 3 months becamea responder at 12, 18 or 24 months.There seems to be a goodcorrelation between vision at 3 and 12 months(correlation coefficient-0.74)and a moderate correlation between 3 and 24 months(correlationcoefficient-0.56)
Ranibizumab treatment in South Wales stabilised the vision in91% of patients and 20% patients gained more than 15 lettersat 24 months. Visual acuity and CRT at 3months is an excellentpredictor for good outcomes at 24 months.Based on the visionand CRT at 3months,we may be able to predict the visual outcomeat 24 months.
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