Intérêt des injections intravitréennes de ranibizumab dans le traitement des néovascularisations choroïdiennes péripapillaires étendues

Abstract

To evaluate the safety and explore the efficacy of intravitreal injection of ranibizumab 0.5mg in treatment of large peripapillary choroidal neovascularization. This single-center, prospective, interventional, noncomparative, nonrandomized clinical case series study included six consecutive patients with large or recurrent peripapillary choroidal neovascularization. Ranibizumab 0.5mg was administered at baseline, and then monthly following the development of hemorrhage or subretinal fluid associated with visual symptoms. The response to treatment was assessed in terms of changes in lesion characteristics as measured by FA and change in visual acuity (VA). Six patients (seven eyes with peripapillary choroidal neovascularization) were enrolled. three of the seven eyes had choroidal neovascularization associated with angioid streaks, two had idiopathic neovascularization, and the last eye had peripapillary neovascular membrane associated with age-related macular degeneration. The median follow-up was 12 months (+/-3 months). At 1 year, the best-corrected visual acuity improved from +0.74 log Mar to +0.45 log Mar (p=0.0431), with resolution of intraretinal fluid. On average, four intravitreal injections of ranibizumab (0.5mg) were required during this year. Laser photocoagulation treatment, photodynamic therapy, or subretinal surgery are limited by the high recurrence rate, the difficulty in assessing the true extent of the lesion, and the difficulty in improving visual function. Intravitreal ranibizumab injections appeared to be a good therapeutic option for patients with peripapillary CNV in the short term. Long-term follow-up of these patients will aid in assessing the sustained effect of the drug.