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Measuring the benefit of 4 years of intravitreal ranibizumab treatment for neovascular age-related macular degeneration
  1. Sreekumari Pushpoth1,
  2. Evripidis Sykakis2,
  3. Kinnar Merchant1,
  4. Andrew C Browning1,
  5. Rajen Gupta1,
  6. S James Talks1
  1. 1Department of Ophthalmology, The Royal Victoria Infirmary, Newcastle upon Tyne, UK
  2. 2Department of Ophthalmology, Whipps Cross University Hospital, London, UK
  1. Correspondence to S James Talks, Department of Ophthalmology, The Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK; James.Talks{at}nuth.nhs.uk

Abstract

Aim To analyse the benefit of intravitreal ranibizumab over 4 years for patients with neovascular age-related macular degeneration (AMD).

Methods A retrospective case note review of all patients who started treatment between August 2007 and September 2009 in our unit, minimum follow-up 2 years, maximum 4 years. The main outcome measures were: numbers of patients with different levels of vision, changes in visual acuity, number of treatments and numbers remaining under follow-up.

Results 1086 eyes of 1017 patients received treatment. Numbers of patients remaining under follow-up were 892/1017 (87.71%) at 12 months, 730/1017 (71.78%) at 24 months, 468/730 (64.11%) at 36 months and 110/217 (50.69%) at48 months. The main reasons for patients no longer being under follow-up were the consequences of old age or transfer of care. 50% of patients had 6/18 or better over 4 years. Patients received on average 5.79±2.53, 9.15±3.79, 11.22±4.92 and 13.7±7.84 injections by 12, 24, 36 and 48 months, respectively.

Conclusions We suggest that the numbers of patients with a particular level of vision may best reflect the actual benefit of AMD treatment provided by a service. Long-term follow-up is required as only 72/730 (10%) had been discharged at 36 months, half of whom had good vision of greater than 60 letters. 83% and 65% of patients needed treatment in the third and fourth year. Follow-up may be for the rest of the patients’ life or at some point they may no longer be well enough to attend.

  • Macula
  • Choroid
  • Degeneration
  • Neovascularisation
  • Treatment other

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