Intravitreal Ranibizumab for retrofoveolar neovascular Age Related Macular Degeneration, in Pseudo vitelliform and/or Drusenoid pigment epithelium detachment shape

Abstract

AbstractPurpose To evaluate the functional, anatomical, vascular flow, effects of intravitreal Ranibizumab injections for retrofoveolar neovascular Pseudo vitelliform and/or Drusenoid pigment epithelium detachment (PED) Age Related Macular Degeneration (AMD), at 3 years 1/2 evolution.Methods 48 eyes of 40 patients, 15 men, 25 women, with neovascular Pseudo vitelliform(35 eyes) and/or Drusenoid PED (13eyes) AMD. Patients received intravitreous Ranibizumab, 3 times, every 4 weeks in an inductive treatment, the next injections (IVT), depending on the follow‐up results, were done by series of 3 IVT. 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.Results VA improved in 52% cases. Angiographic leakage disappeared in 78% cases, reduced about 75% in 40% cases. At ICG ,vascular flow, vessel’s diameter were 2/3 time less in 45% cases, low‐flow in 83% cases .Diffuse edema was normalized in 60% cases , pigment epithelial detachment(PED) was less dense in most of cases, by OCT. No ocular or systemic side effects observed.Better contrast Inductive treatment was sufficient in 24 cases, needed 2 IVT Series in 40% cases, failed in 1 case. In few cases, retinal and pigment epithelium atrophy was induced, Drusenoid PED disappeared.Discussion is open.Conclusion The results, with generally improved visual function, lack of fluorescein leakage, low neovascularisation’s flow in ICG, reduction of exudation on OCT, suggest Series of 3 Ranibizumab IVT Protocol seems effective, in those usually poor resort considered cases.