July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Ranibizumab for Radiation Retinopathy (RRR): A Prospective, Multicenter Trial of Monthly versus PRN Dosing for Radiation Retinopathy-Related Cystoid Macular Edema


Author Affiliations & Notes
  • Amy C Schefler
    Ophthalmology, Retina Consultants of Houston, Houston, Texas, United States
    Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, United States
  • Dwain Fuller
    Texas Retina Associates, Dallas, Texas, United States
  • Rajiv Anand
    Texas Retina Associates, Dallas, Texas, United States
  • Timothy Fuller
    Texas Retina Associates, Dallas, Texas, United States
  • Maria Elena Bretana
    Ophthalmology, Retina Consultants of Houston, Houston, Texas, United States
  • Cassandra Cone
    Ophthalmology, Retina Consultants of Houston, Houston, Texas, United States
  • Chelsey Moore
    Ophthalmology, Retina Consultants of Houston, Houston, Texas, United States
  • Ryan Kim
    Ophthalmology, Retina Consultants of Houston, Houston, Texas, United States
    University of Texas Houston, Houston, Texas, United States
  • Footnotes
    Commercial Relationships   Amy Schefler, Allergan (C), Aura (F), Castle Biosciences (F), Genentech (F), Regeneron (F); Dwain Fuller, None; Rajiv Anand, None; Timothy Fuller, None; Maria Bretana, None; Cassandra Cone, None; Chelsey Moore, None; Ryan Kim, None
  • Footnotes
    Support  Investigator Initiated Trial - grant funding from Genentech
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 5987. doi:
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      Amy C Schefler, Dwain Fuller, Rajiv Anand, Timothy Fuller, Maria Elena Bretana, Cassandra Cone, Chelsey Moore, Ryan Kim; Ranibizumab for Radiation Retinopathy (RRR): A Prospective, Multicenter Trial of Monthly versus PRN Dosing for Radiation Retinopathy-Related Cystoid Macular Edema


      . Invest. Ophthalmol. Vis. Sci. 2018;59(9):5987.

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

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Abstract

Purpose : The purpose of this study was to assess the efficacy of intravitreal ranibizumab for radiation retinopathy-related cystoid macular edema. In this trial, a prospective monthly injection protocol with and without targeted PRP laser was compared to as-needed dosing in radiation retinopathy patients.


Methods : This was a Phase II, multicenter, randomized, controlled clinical trial. Forty patients with macular edema due to radiation retinopathy were randomized 1:2:2 to monthly management versus monthly treatment with targeted PRP versus PRN treatment. Patients with Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) from 20/25 to 20/400 (Snellen equivalent) were randomized to receive intravitreal 0.5 mg ranibizumab monthly with or without PRP to targeted areas of ischemia (TRP) or PRN dosing based on prospective, standardized OCT criteria.

Results : At baseline, mean age was 57 years (range, 22-80 years), mean BCVA was 20/62.5 (Snellen equivalent), and mean central retinal thickness (CRT) was 385 μm. 37 eyes (93%) completed month 6, at which point mean BCVA improved by 6 letters in the monthly cohort, improved by 1 letters in the monthly/TRP cohort, and worsened by 1 letter in the PRN cohort (p<0.001). At month 6, the mean central retinal thickness in the monthly cohort decreased by 152 microns in the monthly cohort, decreased by 123 microns in the monthly/PRP cohort, and decreased by 73 microns in the PRN cohort (p<0.001).

Conclusions : All patients treated with monthly dosing of ranibizumab had an improvement in vision at 6 months compared to baseline and a significant improvement compared to published historical control data. The addition of TRP resulted in a statistically significant reduction of vision at 6 months compared to monthly ranibizumab alone. Patients treated with a PRN strategy, despite anatomic gains, did not experience any improvement in vision during this study period. One year results will also be presented.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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