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I. Bykhovskaya, J. I. Lim; Effect of Ranibizumab (Lucentis) Treatment on Visual Acuity and OCT Central Thickness in Patients Who Had Previously Been Treated With Other Anti-VEGF Agents Compared to Treatment Naïve Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):291.
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To compare the visual and anatomic outcomes of ranibizumab when used as a salvage treatment of age related macular degeneration (AMD) choroidal neovascularization (CNV) with those outcomes in treatment naïve eyes.
We retrospectively reviewed the medical records of AMD patients referred for treatment of subfoveal CNV to identify eyes with CNV treated with ranibizumab over a four month period by one clinician. Eyes were divided into ranibizumab naive and eyes which had received other prior treatment (pegaptanib (Macugen) or bevacizumab (Avastin)) and were switched to ranibizumab due to lack of response or persistent CNV. Main outcome measures were changes in visual acuity and changes in OCT central thickness.
Nineteen eyes in eighteen patients were treated with Lucentis intravitreal injections. Seven (n=7) eyes were treatment naive eyes. Prior anti-VEGF agents included Macugen (n=7), Avastin (n=2), both Macugen and Avastin (consecutively) (n=3). Mean number of Lucentis injections was three per eye. After the Ranibizumab injections, visual acuity (VA) improved in11 eyes, remained the same in 5 eyes, and worsened in 3 eyes at average 2.8 months follow-up. In treatment naive eyes, VA improved in 5 of 7 eyes and remained the same in 2 of 7 eyes at 2.4 months follow-up. No treatment naive eye developed decreased VA. In previously treated eyes, VA improved in 6 of 12 eyes, remained the same in 3 of 12 eyes, and worsened in 3 of 12 eyes after 3.25 months follow up. In treatment naive eyes, VA improved by an average of one line. In prior treatment eyes, VA improved by an average of 0.5 lines. OCT central thickness decreased by an average of 55 in naive eyes and by an average of 23 in previously treated eyes. Neither group of patients developed ocular complications.
Treatment naive eyes had a greater improvement in VA and greater decrease in OCT central thickness than eyes previously treated with other anti-VEGF agents.
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