First Author: M.Buckle UK
Co Author(s): Q. Mohamed R. Johnston 0 0 0 0 0 0 0 0 0
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This study aimed to evaluate longterm visual acuity outcomes in patients receiving ranibizumab for neovascular age-related macular degeneration (nAMD) in Gloucestershire.
Gloucestershire National Health Service Ophthalmology department
Serial visual acuity (VA) and injection data for all treatment-naïve patients receiving their first intravitreal injections of ranibizumab for nAMD in the Gloucestershire National Health Service Ophthalmology department between 1st October 2006 and 24th January 2009 were extracted from an electronic medical record system. 222 patients were included in the study.
Of the 222 patients who received first intravitreal treatment of ranibizumab five or more years ago, 115 patients (51.8%) had four or more years follow up data from time of first injection (“baseline”). The mean number of injections per eye during total follow up period was 19 (3-47). The mean VA in the treated eye at first injection was 54 ETDRS letters; and 50 ETDRS letters in the fellow eye. No patients were eligible for certification of blindness (VA better-seeing eye 25 ETDRS letters or fewer at two consecutive visits) at baseline. At the last recorded follow-up visit (48-60 months from baseline) 6.1% were eligible for blindness certification. At baseline, 2.6% were eligible for certification of sight impairment (VA better-seeing eye 26-39 ETDRS letters), rising to 12.2% at last recorded follow-up. 36.5% had vision sufficient to meet the criteria for holding a UK drivers’ licence (VA better-seeing eye 70 or more ETDRS letters) at baseline, reducing to 33% at last recorded follow up. The second eye was treated in 35.7% of all patients. In patients with “at risk” fellow eyes (VA 35 or more ETDRS letters) the proportion of second eyes treated was 55.6%.
In the early years of ranibizumab treatment for nAMD the first-treated eye was the better-seeing eye more frequently than today (48% compared to 34% in 2013). Despite this, the systematic implementation of ranibizumab services has made the incidence of blindness from nAMD a rare event over 4-5 years of follow-up.