First Author: M.Gil SPAIN
Co Author(s): M. Santiago M. Bande M.J. Rodriguez-Cid B. Pazos F. Gomez-Ulla M.I. Fernandez 0 0 0 0 0 0 0 0 0
Back to previous
To assess the evolution of Visual Acuity (VA) and retinal thickness using Optical Coherence Tomography (OCT) in patients with Exudative Age-Related Macular Degeneration (E-AMD) treated with ranibizumab, according to individualized guidelines, within the context of usual clinical practice in hospitals.
Observational, retrospective, single-centre study.
This is an observational, retrospective, single-centre study. 118 eyes in 100 patients diagnosed with E-AMD were studied. All patients were treated with intravitreous ranibizumab within the context of usual clinical practice between January 2008 and May 2012. Patients received three injections during the loading phase and additional individualized injections during the maintenance phase. The evolution of VA and retinal thickness was analysed using OCT with a minimum period of 12 months of evolution. Data related to the number of treatments performed and characteristics of the neovascular membrane (NVMC) were also gathered.
Average follow-up time was 36 months (minimum 12, maximum 48). After 3 years, improvement (>15 letters) was observed in 6.8% of eyes treated. 78.4% remained stable and 14.9% became worse (<15 letters). Regarding the variation in foveal thickness after three years, taking a variation of ±100 µm from the initial value as a reference, 25% of eyes improved and 14% became worse. Patients who improved obtained an average of 4.5±1.9 injections, unlike those who worsened, who obtained 8.4±1.5 after 3 years of follow-up. No differentiating trends regarding the location and type of NVMC and presence of macular oedema were found.
There is no consensus on ranibizumab treatment guidelines for patients suffering from AMD-E. It has been observed that response after the first year usually marks the later evolution of success or failure of the treatment. Despite the limitations of clinical practice, it appears that stabilization of VA could be achieved with fewer injections. The results shown highlight that eyes that become worse show an average number of injections much greater than those for the 'improvement' and 'stable' groups. This behaviour implies that eyes that do not evolve positively will have little chance of improvement even if the number of treatments is increased. It is important to identify patients who respond to treatment in order to optimize it.