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S. Wolf, R. Ruehl, C. Framme, U. E. K. Wolf-Schnurrbusch; Results of Treatment of Exudative ARMD With Ranibizumab in a Clincal Setting. Invest. Ophthalmol. Vis. Sci. 2010;51(13):901.
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Neovascular age-related macular degeneration (ARMD) has a poor prognosis if left untreated, frequently resulting in legal blindness. Ranibizumab (Lucentis®; Novartis Pharma AG, Basel, Switzerland;) is approved for treating neovascular ARMD since early 2006 in Switzerland. Although preliminary guidelines for anti-VEGF therapies exist, more comprehensive clinical practice guidelines on applying ranibizumab are needed to assist ophthalmologists in clinical practice and to optimise patient outcomes.
We have analyzed the patient outcomes in the clinical practice and compared with data available from prospective, multicentre studies evaluating different ranibizumab treatment schedules. Our treatment regimen consists of an initial treatment with 3 monthly Lucentis injections followed by PRN administration of Lucentis. Retreatment consists of quarterly Lucentis injections in patients with inactive lesions and monthly injections in patients with active lesions. Each time we diagnose an active lesion patients receive a series of three monthly injections.
We included 202 patients (65 m, 137 f) with exudative ARMD aged from 52 - 93 years (mean: 78 ± 8 years) into this retrospective analysis. Follow-up ranged from 3-32 months (mean 16 ± 6 months). At baseline mean ETDRS visual acuity was 53 ± 17 letters. Visual acuity 1 months after the initial 3 monthly lucentis injections was 60 ± 16 letters, at 6 months visual acuity was 58 ± 17 letters, at 12 months 59 ± 16 letters, and at 24 months after initial treatment 60 ± 17 letters. The number of injections ranged between 10 and 20 injections (mean: 13 ± 5 ) over 24 months.
Using our "intensified" PRN regimen we can archive similar results as the pivotal trials. We feel that retreatment with quarterly injections even in eyes with inactive lesion is an important factor for our promising results.
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