3 Intravitreal ranibizumab injections series for the treatment of neovascular age‐related macular degeneration (AMD), 18 months follow‐up

Abstract

Abstract Purpose To evaluate the functional, anatomical, vascular flow effects of intravitreal Ranibizumab injections(IVT) for retrofoveolar neovascular AMD, done with a series of 3 IVT protocol, and the recurrences frequency at 1 ½ year evolution. Methods 227 eyes of 179 patients, 58 men, 121 women, with retrofoveolar neovascularisation complicating AMD. Patients received intravitreous Ranibizumab, 3 times, every 4 weeks in an inductive treatment. The next injections depended on the follow‐up results, and were done by series of 3. First and 2 months’ interval follow‐up exam included ETDRS visual acuity (VA), complete ophthalmic examination, fluorescein and infracyanine (ICG) angiography, and optical coherence tomography (OCT).VA and OCT were done before each IVT. We want to evaluate the incidence of this protocol on the frequency of recurrences so on the number of IVT needed. Results VA improved in 48% cases, more than 10 letters in 25% cases. Angiographic leakage reduced about 70% in 53% cases. At ICG ,vascular flow, vessel’s diameter were 2/3 time less in 62% cases. Diffuse edema was 30% reduced in 85% , pigment epithelial detachment was flattened and less dense in all cases, by OCT. Most of patients had good functional, anatomical, vascular flow, results, with less IVT needed. Inductive treatment was sufficient in 113 cases,more series were necessary in 114 cases.Mean stability period was 3 months. Conclusion The results, with generally improved visual function, less and/or stable neovascular activity in FA‐ICG‐OCT, less recurrences, suggest series of 3 Ranibizumab IVT seem effective, less restrictive,more retinal protective, lastly cheaper. This protocol seems attractive, its indication must be optimized.