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The significance of early treatment of exudative age-related macular degeneration: 12 months’ results

Die Wichtigkeit einer frühen Behandlung bei exsudativer altersabhängiger Makuladegeneration – 12 Monats-Ergebnisse

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Summary

Background

To assess whether the period between initial symptoms and therapy with ranibizumab in patients with choroidal neovascularization (CNV) influences visual outcome after a follow-up of 12 months.

Methods

Fifty patients with CNV were retrospectively split into three groups depending on the duration of visual symptoms: group I: < 1 month, group II: 1–6 months, and group III: > 6 months. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were recorded at baseline, 2, 6, and 12 months. Patients received two initial intravitreal injections of 0.5 mg ranibizumab at baseline and reinjections as needed.

Results

The mean time span between initial symptoms and treatment was 66 ± 63 days. A longer duration of visual symptoms was significantly correlated with a lower BCVA at baseline, but also after 6 and 12 months.

Conclusions

Shorter duration of visual symptoms prior to treatment is associated with a better visual outcome.

Zusammenfassung

Hintergrund

Ziel dieser Studie war es, einen möglichen zeitlichen Einfluss zwischen Auftreten von Symptomen und Beginn einer Therapie bei choroidaler Neovaskularisation (CNV) auf das Sehvermögen nach einem Beobbachtungszeitraum von 12 Monaten herauszufinden.

Methodik

Fünfzig PatientInnen mit CNV wurden retrospektiv in drei Gruppen abhängig von der Symptomdauer geteilt: Gruppe I: < 1 Monat, Gruppe II: 1–6- Monate, Gruppe III: > 6 Monate. Der bestkorrigierte Visus und die zentrale Netzhautdicke wurden zu Beginn, nach 2, 6 und 12 Monaten erhoben. Die PatientInnen erhielten zwei initiale Injektionen mit 0,5 mg Ranibizumab in den Glaskörper. Weitere Injektionen wurden bei Bedarf verabreicht.

Ergebnisse

Die durchschnittliche Dauer zwischen Erstauftreten der Symptome und Beginn der Behandlung betrug 66 ± 63 Tage. Eine längere Symptomdauer korrelierte signifikant mit einem schlechteren Ausgangsvisus, aber auch mit einem schlechteren Sehvermögen nach 6 und 12 Monaten.

Schlussfolgerungen

Je kürzer die Symptomdauer vor Beginn der Behandlung ist, desto besser ist das Visusergebnis nach 12 Monaten.

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References

  1. Kahn HA, Leibowitz HM, Ganley JP, et al. The Framingham Eye Study. I. Outline and major prevalence findings. Am J Epidemiol. 1977;106:17–32.

    PubMed  CAS  Google Scholar 

  2. Klaver CC, Wolfs RC, Vingerling JR, Hofman A, de Jong PT. Age-specific prevalence and causes of blindness and visual impairment in an older population: the Rotterdam Study. Arch Ophthalmol. 1998;116:653–8.

    PubMed  CAS  Google Scholar 

  3. Spitzer MS, Ziemssen F, Bartz-Schmidt KU, Gelisken F, Szurman P. Treatment of age-related macular degeneration: focus on ranibizumab. Clin Ophthalmol. 2008;2:1–14.

    Article  PubMed  CAS  Google Scholar 

  4. Macular Photocoagulation Study Group. Five-year follow-up of fellow eyes of patients with age-related macular degeneration and unilateral extrafoveal choroidal neovascularization. Arch Ophthalmol. 1993;111:1189–99.

    Article  Google Scholar 

  5. Barouch FC, Miller JW. Anti-vascular endothelial growth factor strategies for the treatment of choroidal neovascularization from age-related macular degeneration. Int Ophthalmol Clin. 2004;44:23–32.

    Article  PubMed  Google Scholar 

  6. Rosenfeld PJ, Brown DM, Heier JS, et al. MARINA Study Group. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355:1419–31.

    Article  PubMed  CAS  Google Scholar 

  7. Furino C, Boscia F, Recchimurzo N, et al. Intravitreal bevacizumab for treatment-naive subfoveal occult choroidal neovascularization in age-related macular degeneration. Acta Ophthalmol. 2009;87:404–7.

    Article  PubMed  CAS  Google Scholar 

  8. Kaiser PK. Antivascular endothelial growth factor agents and their development: therapeutic implications in ocular diseases. Am J Ophthalmol. 2006;42:660–8.

    Article  Google Scholar 

  9. Ladewig MS, Karl SE, Hamelmann V, et al. Combined intravitreal bevacizumab and photodynamic therapy for neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol. 2008;246:17–25.

    Article  PubMed  CAS  Google Scholar 

  10. Ng EW, Adamis AP. Targeting angiogenesis, the underlying disorder in neovascular age-related macular degeneration. Can J Ophthalmol. 2005;40:352–68.

    PubMed  Google Scholar 

  11. Singer MA, Awh CC, Sadda S, et al. HORIZON: An open-label extension trial of ranibizumab for choroidal neovascularization secondary to age-related macular degeneration. Ophthalmology. 2012;119(6):1175–83.

    Article  PubMed  Google Scholar 

  12. Brown DM, Kaiser PK, Michels M, et al. ANCHOR Study Group. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006;355:1432–44.

    Article  PubMed  CAS  Google Scholar 

  13. Boyer DS, Antoszyk AN, Awh CC, Bhisitkul RB, Shapiro H, Acharya NR. MARINA Study Group. Subgroup analysis of the MARINA study of ranibizumab in neovascular age-related macular degeneration. Ophthalmology. 2007;114:246–52.

    Article  PubMed  Google Scholar 

  14. Rosenfeld PJ, Rich RM, Lalwani GA. Ranibizumab: Phase III clinical trial results. Ophthalmol Clin North Am. 2006;19:361–72.

    PubMed  Google Scholar 

  15. Lalwani GA, Rosenfeld PJ, Fung AE, et al. A variable-dosing regimen with intravitreal ranibizumab for neovascular age-related macular degeneration: year 2 of the PrONTO Study. Am J Ophthalmol. 2009;148(1):43–58.

    Article  PubMed  CAS  Google Scholar 

  16. Klein ML, Jorizzo PA, Watzke RC. Growth features of choroidal neovascular membranes in age-related macular degeneration. Ophthalmology. 1989;96:1416–9.

    PubMed  CAS  Google Scholar 

  17. Vander JF, Morgan CM, Schatz H. Growth rate of subretinal neovascularization in age-related macular degeneration. Ophthalmology. 1989;96:1422–6.

    PubMed  CAS  Google Scholar 

  18. Muether PS, Hermann MM, Koch K, Fauser S. Delay between medical indication to anti-VEGF treatment in age-related macular degeneration can result in a loss of visual acuity. Graefes Arch Clin Exp Ophthalmol. 2011;249:633–7.

    Article  PubMed  CAS  Google Scholar 

  19. Schalnus R, Meyer CH, Kuhli-Hattenbach C, Luchtenberg M. Time between symptom onset and assessment in age-related macular degeneration with subfoveal choroidal neovascularization. Ophthalmologica. 2010;224:176–82.

    Article  PubMed  Google Scholar 

  20. Oliver-Fernandez A, Bakal J, Segal S, Shah GK, Dugar A, Sharma S. Progression of visual loss and time between initial assessment and treatment of wet age-related macular degeneration. Can J Ophthalmol. 2005;40:313–9.

    PubMed  Google Scholar 

  21. Algvere PV, Steén B, Seregard S, Kvanta A. A prospective study on intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration of different durations. Acta Ophthalmol. 2008;86:482–9.

    Article  PubMed  CAS  Google Scholar 

  22. Rauch R, Weingessel B, Maca SM, Vécsei-Marlovits PV. Time to first treatment—the significance of early treatment of exudative age related macular degeneration. Retina. 2011;32(7):1260–4.

    Google Scholar 

  23. Heimes B, Lommatzsch A, Zeimer M, et al. Long-term visual course after anti-VEGF therapy for exudative AMD in clinical practice evaluation of the German reinjection scheme. Graefes Arch Clin Exp Ophthalmol. 2011;249:639–44.

    Article  PubMed  CAS  Google Scholar 

  24. Dadgostar H, Ventura AA, Chung JY, Sharma S, Kaiser PK. Evaluation of injection frequency and visual acuity outcomes for ranibizumab monotherapy in exudative age-related macular degeneration. Ophthalmology. 2009;116:1740–7.

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors have no proprietary interest in any material presented in the study. Pia Veronika Vecsei-Marlovits and Birgit Weingessel received support by the Novartis Company for presentations and consultancy not associated with this study.

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Authors and Affiliations

  1. Department of Ophthalmology, Hietzing Hospital, Wolkersbergenstrasse 1, 1130, Vienna, Austria

    Birgit Weingessel MD, Saskia M. Maca MD, Renate Rauch MD &  Pia Veronika Vecsei-Marlovits MD

  2. Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery, Vienna, Austria

    Birgit Weingessel MD, Renate Rauch MD &  Pia Veronika Vecsei-Marlovits MD

  3. Department of Ophthalmology, St. Poelten Hospital, St. Poelten, Austria

    Gregor Hintermayer MD

Authors
  1. Birgit Weingessel MD
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  2. Gregor Hintermayer MD
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  3. Saskia M. Maca MD
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  4. Renate Rauch MD
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  5. Pia Veronika Vecsei-Marlovits MD
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Correspondence to Pia Veronika Vecsei-Marlovits MD.

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Weingessel, B., Hintermayer, G., Maca, S. et al. The significance of early treatment of exudative age-related macular degeneration: 12 months’ results. Wien Klin Wochenschr 124, 750–755 (2012). https://doi.org/10.1007/s00508-012-0249-3

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  • DOI: https://doi.org/10.1007/s00508-012-0249-3

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