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C. P. Castiblanco, R. A. Adelman; Visual Acuity and Central Macular Thickness in Patients Treated With Anti-Angiogenic Intravitreal Injections for Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2008;49(13):267.
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To report the frequency of intravitreal injections, central macular thickness and visual acuity changes in a series of patients with AMD treated with ranibizumab alone versus those treated in combination with bevacizumab, pegaptanib sodium or photodynamic therapy (PDT).
Retrospective study of patients treated from 2005 to 2007. Central macular thickness (CMT) and visual acuity (VA) measurements were recorded at the initial injection of ranibizumab and at 3, 6, and 12 months.
Fifty-three eyes of 50 patients were studied. Eighteen eyes were injected with ranibizumab alone and 35 eyes had injections of pegaptanib sodium, bevacizumab or PDT prior to ranibizumab. From these 35 eyes, 13 eyes had PDT. Mean follow-up was 9.9 months. A mean of 6 ranibizumab injections/year were given to patients with at least 12 months of follow-up. Injections were done at a monthly basis for the first 3 months and then as needed based on OCT. The 18 eyes with ranibizumab alone had an initial mean VA of 20/250 and CMT of 320 µm, followed by 20/200 and 265 µm at 3 months, 20/320 and 287 µm at 6 months and 20/200 and 256 µm at 12 months. Eighteen eyes received pepaptanib sodium and then switched to ranibizumab. At the start of pegaptanib injections, the initial VA was 20/150. Upon changing to ranibizumab, the mean VA was 20/250 and mean CMT was 270 µm. Followed by 20/200 and 239 µm at 3 months, 20/160 and 243 µm at 6 months, and 20/200 and 256 µm at 12 months. Eight eyes received bevacizumab and switched to ranibizumab. The VA at the start of bevacizumab therapy was 20/320. Upon starting ranibizumab, the mean VA remained 20/320 and CMT was 234 µm. It changed to 20/125 and 213 µm at 3 months, 20/400 and 202 µm at 6 months and 20/200 and 215 µm at 12 months. Seven eyes had pegaptanib and bevacizumab injections prior to switching to ranibizumab. Initial mean VA at start of therapy with pegaptanib was 20/400 and 20/800 with bevacizumab. At the 1st ranibizumab injection, mean VA was 20/800 and CMT was 325 µm. Followed by 20/800 and 232 µm, 20/400 and 274 µm, and 20/320 and 247 µm at 3, 6, and 12 months respectively.
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