Abstract
Introduction::
Ranibizumab (LucentisTM) was recently approved by the FDA for the treatment of neovascular age-related macular degeneration (AMD). Ranibizumab is a humanized antigen-binding antibody fragment (Fab) that is known to inhibit all biologically active forms of vascular endothelial growth factor-A and its degradation products.
Purpose::
This retrospective case series reports on patients with neovascular AMD who responded well after switching to intravitreal (ITV) ranibizumab treatment from off-label ITV bevacizumab (AvastinTM) treatment with or without prior photodynamic therapy (PDT).
Methods::
Fifteen consecutive patients (mean age, 78) who previously received and responded poorly to ITV bevacizumab (1-2 injections) with or without prior PDT (n = 12) were evaluated. Patients received monthly ITV injections of ranibizumab (0.5 mg; 1-5 injections), and their macula was examined with optical coherence tomography (OCT) at each study visit.
Results::
Prior to ranibizumab injection, OCT demonstrated the presence of cystic spaces, subretinal fluid, or retinal pigment epithelial detachment in these patients despite ITV injections of bevacizumab and, in many cases, multiple PDT sessions. Nearly, all patients experienced significant resolution of fluid after a single ITV ranibizumab injection. Thus far, no serious ocular or systemic adverse events have been reported.
Conclusions::
Patients with neovascular AMD that is intractable to off-label ITV bevacizumab and to PDT may have a prompt response to ranibizumab. This is demonstrated by a rapid decrease in fluid in the macula as noted on OCT.
Keywords: age-related macular degeneration • retina • clinical (human) or epidemiologic studies: outcomes/complications