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R. A. Sisk, N. Z. Gregori; Safety and Efficacy of Intravitreal Ranibizumab (Lucentis) for the Treatment of Macular Edema Not Secondary to Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2684.
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To evaluate the safety and efficacy of off-label intravitreal ranibizumab (Lucentis®, Genentech) for the treatment of macular edema (ME) from causes other than exudative age-related macular degeneration (AMD). Secondly, to determine if different etiologies of macular edema respond more or less favorably to anti-vascular endothelial growth factor (VEGF) therapy.
Retrospective consecutive noncomparative case series. A chart review was performed of all eyes treated with intravitreal ranibizumab for ME secondary to any non-AMD etiology at the Miami Veterans Affairs Medical Center between October 31, 2006 and October 31, 2007. All patients underwent routine Snellen visual acuity (VA) assessment and Stratus OCT (Carl Zeiss Meditech, Inc.) imaging with 1 mm central retinal thickness measurements as part of their routine clinical care. The dose of ranibizumab was 0.5 mg (0.05 ml). Retreatment was performed at monthly or longer intervals at the discretion of the treating physician.
48 consecutive patients were treated with intravitreal ranibizumab for ME due to diffuse diabetic macular edema (24), branch retinal vein occlusion (8), central retinal vein occlusion (9), Irvine-Gass syndrome (6), and idiopathic macular telangiectasia (1). Improvement in VA and OCT central retinal thickness measurements was observed in each group of patients. Overall, central retinal thickness measurements by OCT improved to a greater degree than VA.
Retinal vein occlusion patients demonstrated the best response to ranibizumab compared to other groups of patients suggesting that venous occlusive disease is mostly a VEGF-driven process and other pro-inflammatory mediators might be more important in diabetes and post-surgical inflammation.
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