Abstract
BackgroundTo identify risk factors for being a “reduced responder” to ranibizumab treatment in a clinical setting in patients with neovascular age-related macular degeneration.MethodsThis retrospective study included 165 eyes of 165 consecutive patients with choroidal neovascularisation secondary to neovascular, age-related macular degeneration. Eyes were treated with three intravitreal injections of ranibizumab, followed by PRN (pro re nata) dosing thereafter. All patients were reevaluated every four weeks and then followed for six months. Reduced responders were defined as patients with a loss in visual acuity of at least 1 visual acuity line at the last follow-up and/or persistent intraretinal or subretinal fluid or detectable choroidal neovascularisation at the last follow-up, compared to baseline.ResultsOverall, 58 out of 165 eyes (35.2%) were considered to be reduced responders to treatment at the end of follow-up. The initial CNV size at baseline was correlated with the risk of being a reduced responder at the end of follow-up (p = 0.017).ConclusionWe identified the initial lesion size as a predictor for a reduced response to treatment in this study. Patients with a large initial lesion size should be thoroughly informed about the possible poorer response to the intravitreal treatment.
Highlights
To identify risk factors for being a “reduced responder” to ranibizumab treatment in a clinical setting in patients with neovascular age-related macular degeneration
Ranibizumab is a humanised antigen-binding fragment (Fab) that targets all isoforms of vascular endothelial growth factor A (VEGF-A) and is approved by the Food and Drug Administration for the treatment of patients with neovascular age-related macular degeneration (AMD), as well as diabetic macular oedema and macular oedema following retinal vein occlusion
We investigated the determinants of a reduced response to treatment, defined as patients who revealed a reduction in visual acuity of at least 1 visual acuity line and/or persistent or recurrent retinal fluid or choroidal neovascularisation after six months of treatment, compared to baseline, after primary intravitreal ranibizumab therapy for choroidal neovascular lesions secondary to AMD
Summary
To identify risk factors for being a “reduced responder” to ranibizumab treatment in a clinical setting in patients with neovascular age-related macular degeneration. Ranibizumab is a humanised antigen-binding fragment (Fab) that targets all isoforms of vascular endothelial growth factor A (VEGF-A) and is approved by the Food and Drug Administration for the treatment of patients with neovascular age-related macular degeneration (AMD), as well as diabetic macular oedema and macular oedema following retinal vein occlusion. There are very few current predictors of visual outcome In this retrospective study, the treatment of neovascular macular degeneration consisted of three consecutive injections of ranibizumab, followed by PRN dosing thereafter in a clinical setting. We investigated the determinants of a reduced response to treatment, defined as patients who revealed a reduction in visual acuity of at least 1 visual acuity line and/or persistent or recurrent retinal fluid or choroidal neovascularisation after six months of treatment, compared to baseline, after primary intravitreal ranibizumab therapy for choroidal neovascular lesions secondary to AMD
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