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  • Effectiveness of ranibizumab for neovascular age-related macular degeneration using clinician-determined retreatment strategy

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Clinical science
Original article
Effectiveness of ranibizumab for neovascular age-related macular degeneration using clinician-determined retreatment strategy
  1. A Kumar1,
  2. J N Sahni1,
  3. A N Stangos1,
  4. C Campa1,
  5. S P Harding1,2
  1. 1St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
  2. 2Ophthalmology Research Unit, School of Clinical Sciences, University of Liverpool, UK
  1. Correspondence to J N Sahni, St Paul's Eye Unit, Royal Liverpool University Hospital, Prescot St, Liverpool L7 8XP, UK; jayashreesahni{at}yahoo.co.uk

Aims To report the effectiveness of intravitreal ranibizumab treatment for neovascular age-related macular degeneration in a tertiary centre.

Methods 1 year prospective cohort study of patients with a diagnosis of neovascular age-related macular degeneration on fundus fluorescein angiography treated with ranibizumab. Patients received three consecutive monthly treatments, followed by a clinician-determined re-treatment strategy. Data collected included demographic details, baseline and subsequent follow-up visit measurements, refraction protocol best corrected visual acuity (BCVA), contrast sensitivity (CS) and central foveal thickness (CFT) on optical coherence tomography.

Results 81 patients were included in the study. The mean age was 79.5 years with a male:female ratio 32:49. The mean number of treatments was 5.6±2.3. Visual outcomes at 12 months showed 17.1% gained ≥15 letters BCVA, 97.4% lost <15 letters and 2.5% lost ≥15 letters. Mean changes at 12 months were: BCVA +3.7±11.1 (p<0.01); CS +2.3±5.1 letters (p<0.001); CFT −100.1±111.9 μm (p<0.001).

Conclusions Clinician-determined re-treatment after a three-dose initiation phase appears to be less effective in improving BCVA than in randomised controlled trials.

  • Age-related macular degeneration
  • ranibizumab
  • retina
  • neovascularisation
  • treatment other

https://doi.org/10.1136/bjo.2009.171868

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    Aims To report the effectiveness of intravitreal ranibizumab treatment for neovascular age-related macular degeneration in a tertiary centre.

    Methods 1 year prospective cohort study of patients with a diagnosis of neovascular age-related macular degeneration on fundus fluorescein angiography treated with ranibizumab. Patients received three consecutive monthly treatments, followed by a clinician-determined re-treatment strategy. Data collected included demographic details, baseline and subsequent follow-up visit measurements, refraction protocol best corrected visual acuity (BCVA), contrast sensitivity (CS) and central foveal thickness (CFT) on optical coherence tomography.

    Results 81 patients were included in the study. The mean age was 79.5 years with a male:female ratio 32:49. The mean number of treatments was 5.6±2.3. Visual outcomes at 12 months showed 17.1% gained ≥15 letters BCVA, 97.4% lost <15 letters and 2.5% lost ≥15 letters. Mean changes at 12 months were: BCVA +3.7±11.1 (p<0.01); CS +2.3±5.1 letters (p<0.001); CFT −100.1±111.9 μm (p<0.001).

    Conclusions Clinician-determined re-treatment after a three-dose initiation phase appears to be less effective in improving BCVA than in randomised controlled trials.

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    Footnotes

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval This study was conducted with the approval of the Liverpool Research Ethics Committee (LREC ref 02/051).

    • Provenance and peer review Not commissioned; externally peer reviewed.