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A. Y. Lee, B. T. Smith, S. Mehta, M. A. Brantley, Jr.; Efficacy of Ranibizumab for the Treatment of Neovascular Age-Related Macular Degeneration in a Practical Clinical Setting. Invest. Ophthalmol. Vis. Sci. 2008;49(13):342.
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To evaluate the efficacy of intravitreal ranibizumab in a practical clinical setting for the treatment of neovascular age-related macular degeneration (AMD).
A retrospective, noncomparative study of our first 164 consecutive, treatment-naive patients was conducted to determine pre-injection Snellen visual acuities, lesion characteristics, number of required injections, phakic status, vitreous status, and final vision. Most eyes were given an induction of three injections followed by "as needed" injections.
Follow up averaged 11.0 months. Mean baseline visual acuity (VA) was 20/150 (0.87 logMAR). Forty-five eyes (27%) had a pre-treatment VA ≤ 20/400. The mean greatest linear diameter was 2870 µm. Sixty percent had occult lesions and 68% were subfoveal. Twelve percent had an associated detachment of the retinal pigment epithelium. The mean number of required injections was 4.3 (range 1-11). The mean change in VA after treatment was a gain of 0.05 (-2.0 to 1.7). Visual acuity was stabilized (VA loss < 0.3 logMAR) in 136 eyes (83%) and improved greater than 3 lines (≥ 0.3 logMAR) in 47 eyes (29%).
The inclusion of patients with poorer baseline visual acuity may reduce the measured effect of ranibizumab in the treatment of neovascular AMD when compared to data from randomized clinical trials. Nevertheless, ranibizumab is effective in achieving visual stabilization in most eyes with neovascular AMD even when administered on an "as needed" basis in a practical clinical setting.
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