First Author: B.J.Vote AUSTRALIA
Co Author(s): S.Y.P. Ewe R.G. Abell D.L. Lim N.M. Kerr P.L. Allen 0 0 0 0 0 0 0 0 0
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To evaluate safety and efficacy of treatment with intravitreal ranibizumab for neovascular age-related macular degeneration in a clinical setting.
In-theatre and in-office setting
A nonrandomized, single-surgeon, retrospective, interventional cases series of 522 patients (626 eyes) with neovascular age-related macular degeneration treated with intravitreal ranibizumab between September 2006 and May 2011.
In total 5,983 injections were administered at mean interval of 6.9 weeks and mean follow-up of 15.7 months. Overall, BCVA improved a mean of 2.1 letters from baseline to endpoint of study period. Mean BCVA improvement at 1-year follow-up was 11 letters. Nearly 50% of patients maintained driving standard and 1/3 were living alone independently. Smaller lesion size (<1 disc area) was associated with significant improvement (p=0.0039).
Cautious inject and extend (capped extend) methods with less frequent comprehensive examinations in selected patients can result in good visual acuity outcomes in a clinical setting but does not match monthly clinical trial results. Under-treatment (evidenced by disease recurrence) remains an important obstacle to obtaining best outcomes as we seek to individualize therapy for patients and reduce treatment burden. Small lesion size and better baseline vision are proxy markers for time to treatment and increased education and resources are needed to improve time to treatment initiation.