May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Treatment of Neovascular Age-Related Macular Degeneration With Ranibizumab After Bevacizumab: Effect on Persistent Macular Edema and Subretinal Fluid
Author Affiliations & Notes
  • C. W. Leng
    Ophthalmology and Vision Science, University of California, Davis, Sacramento, California
  • C. C. Cessna
    Ophthalmology and Vision Science, University of California, Davis, Sacramento, California
  • S. N. Truong
    Ophthalmology and Vision Science, University of California, Davis, Sacramento, California
  • D. G. Telander
    Ophthalmology and Vision Science, University of California, Davis, Sacramento, California
  • S. Park
    Ophthalmology and Vision Science, University of California, Davis, Sacramento, California
  • L. S. Morse
    Ophthalmology and Vision Science, University of California, Davis, Sacramento, California
  • Footnotes
    Commercial Relationships C.W. Leng, None; C.C. Cessna, None; S.N. Truong, None; D.G. Telander, None; S. Park, None; L.S. Morse, None.
  • Footnotes
    Support None.
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 3377. doi:
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    • Get Citation

      C. W. Leng, C. C. Cessna, S. N. Truong, D. G. Telander, S. Park, L. S. Morse; Treatment of Neovascular Age-Related Macular Degeneration With Ranibizumab After Bevacizumab: Effect on Persistent Macular Edema and Subretinal Fluid. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3377.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: To evaluate the effect of intravitreal ranibizumab on persistent macular edema and/or subretinal fluid among patients with neovascular age-related macular degeneration (ARMD) previously treated with intravitreal bevacizumab.

Methods:: Eight eyes of eight patients with neovascular ARMD with persistent macular edema and/or subretinal fluid seen on Stratus optical coherence tomography (OCT) after at least 3 monthly injections of intravitreal Bevacizumab (1.25 mg) were identified. These eyes were subsequently treated with at least 3 monthly intravitreal injections of Ranibizumab (0.5 mg). Best-corrected visual acuity (BCVA) and Stratus OCT imaging were compared before and after intravitreal Ranibizumab treatments.Patients who had undergone unsuccessful treatment with other modalities, including PDT, pegaptanib and/or IVTA in the past were included in this series. An average of 3.75 injections of bevacizumab (range 3-6) were administered every 4-8 weeks. These patients were found to have persistent cystoid macular edema and/or subretinal fluid after at least three injections of bevacizumab.Subsequently, all eight eyes received an average of 3.75 intravitreal injections of ranibizumab 0.5mg (range 3-5). Follow-up ranged from 6 to 11 months at the time of this abstract. Primary outcome was qualitative persistence of cystoid macular edema and/or subretinal fluid by Stratus OCT after treatment with ranibizumab. Secondary outcome was failure of ranibizumab to prevent worsening of BCVA.

Results:: All eight eyes received an average of 3.75 intravitreal injections of ranibizumab (range 3 to 5). Follow-up period ranged from 6 to 11 months. OCT findings remained unchanged in all eight patients after treatment with ranibizumab with persistence of subretinal fluid and/or cystoid macular edema. BCVA worsened in three patients and remained relatively unchanged in five.

Conclusions:: Eyes with neovascular AMD with persistent cystoid macular edema and/or subretinal fluid after treatment with intravitreal bevacizumab do not appear to have any further improvement when treatment is changed to intravitreal ranibizumab.

Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • imaging/image analysis: clinical 
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