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M. Niskopoulou, A. Kotsolis, P. Massaoutis, S. Mpaltatzis, I. D. Ladas; The Use of Ranibizumab in Age Related Macular Degeneration Patients With Low Visual Acuity. Invest. Ophthalmol. Vis. Sci. 2010;51(13):914.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effectiveness of ranibizumab intravitreal injections in patients with exudative age related macular degeneration (ARMD) and poor visual acuity.
19 eyes of 19 patients were included in this retrospective study. Inclusion criteria were a working diagnosis of age related macular degeneration, visual acuity less or equal to 1.0 of logMar chart and the clinical and angiographic presence of active choroidal neovascularisation, with less of 50% of the lesion being fibrosed. They were treated with ranibizumab injections, following a modified ‘inject and extend’ technique. Visual acuity and OCT thickness of the lesion were assessed at the pre- treatment visit and at the end of the follow-up time. In this study, the gain of ≥3 lines in the logMar chart was considered significant improvement in visual acuity. The reduction of thickness by 100µ in the OCT was also, considered significant.
Mean follow-up time was 8.7 months (±3.3). Mean VA before the initiation of treatment was 1.23 (±0.25) improving to 0.8 (± 0.44) at the end of the follow up time. Mean thickness in OCT prior to treatment was 412µ (±130.3) and decreased to 299.5µ (±80.23). Mean number of injections was 6.8 (±2.3). There was statistical significant improvement in the VA (p<0.001), as well as reduction in the lesion thickness measured in the OCT (p<0.01). 9 out of 19 patients (47.4%) showed significant improvement in visual acuity. 11 out of 19 patients (58%) had significant reduction in the OCT measurement at the end of the follow up time.
It has been suggested that low visual acuity at the initiation of treatment in age related macular degeneration, predicts a poor outcome and possibly has no effect at all in a significant number of cases. Our study suggests that even in very low initial visual acuity, in the presence of active lesion, treatment with ranibizumab may warrant a surprisingly good result.
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