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T. B. Connor; Intravitreal Ranibizumab for Neovascular Macular Degeneration in Previously Vitrectomized Eyes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):928.
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To examine intravitreal therapy (IVT) with ranibizumab in patients with neovascular age-related macular degeneration (AMD) who have had previous pars plana vitrectomy (PPV). Eyes with previous PPV would have been excluded from IVT trials. It is unclear what effect previous PPV would have on IVT.
Review of medical records from July 2006-July 2009 of patients receiving IVT of ranibizumab for neovascular AMD who had previously undergone PPV in that same eye for a different indication. Patients with diabetic retinopathy or retinal vein occlusion were excluded.
10 patients (6 women, 4 men)were identified; age range 61-92 years (mean 80.6 years). Reasons for previous PPV: retained lens material following cataract surgery (3), retinal detachment (2), epiretinal membrane (2), non-clearing vitreous hemorrhage from posterior vitreous separation (2), dislocated intraocular lens (1). TIme from PPV to diagnosis of neovascular AMD: 2-12 years (mean 5.8 years). Vision at time of diagnosis of neovascular AMD: 20/60 - 20/400 (mean 20/182). Number of monthly injections of ranibizumab until retinal hemorrhage, edema, and subretinal fluid had resolved and confirmed with time domain OCT: 3-9 injections (mean 5.6 injections). Vision at this time point: 20/30 - 20/150 (Mean 20/74). Snellen lines gained: 1-5 lines (mean 3 lines). 6 patients gained 3 or more lines. VIsion gains have been maintained in follow-up of 6-12 months (mean 8.2 months).
IVT with ranibizumab may be helpful in patients with neovascular AMD who have had previous vitrectomy. The vitrectomized state did not require more frequent treatment than standard therapy. The favorable treatment response in this group may warrant further investigation.
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