Intravitreal Ranibizumab for Pigment Epithelium Detachment With Subfoveal Occult Choroidal Neovascularization: A Prospective 24-Month Case Series

Abstract

To assess the effects of intravitreal ranibizumab injection in patients affected by pigment epithelial detachment associated with occult subfoveal choroidal neovascularization. Prospective, interventional case series. Forty eyes of 40 patients were considered for the purpose of the study. Consecutive patients were recruited for a 24-month study. All patients underwent a complete ophthalmic examination, including best-corrected visual acuity on Early Treatment Diabetic Retinopathy Study (ETDRS) charts. After a 3-monthly loading phase, further intravitreal ranibizumab injections were administered on the basis of detection of any type of fluid on optical coherence tomography. Changes in mean best-corrected visual acuity at 12 and 24months and the proportion of eyes losing fewer than 15 letters (corresponding to 3 ETDRS lines) from baseline visual acuity. Changes in central macular thickness on optical coherence tomography and variation in mean area of the entire lesion. Forty patients were included. Mean best-corrected visual acuity decreased from 20/66 (58 ETDRS letters) to 20/83 (53 letters) at 12months and 20/112 (489 ETDRS letters) at 24months (P= .003). Eighty percent and 67.5% of eyes lost fewer than 3 lines at 12 and 24months, respectively. Mean central macular thickness passed from 545μm to 428μm at 12months and 426μm at 24months. Mean lesion area changed from 6826μm(2) to 6312μm(2) at 12months and 6010μm(2) at 24months. The treatment of pigment epithelial detachment associated with occult subfoveal choroidal neovascularization with intravitreal ranibizumab injection after a 3-monthly loading phase and pro re nata strategy can lead to partial results over a 24-month follow-up. Further investigations are warranted to establish the best therapeutic approach to this disease.