Dose Of Intravitreal Ranibizumab Research Articles

Lack of Response to Intravitreal Ranibizumab Treatment in Adult Onset Foveomacular Vitelliform.

Adult-onset foveomacular vitelliform dystrophy (AOFVD) is a rare disease characterized by accumulation of yellowish deposits in the macula. Rarely, it may be complicated by choroidal neovascularization (CNV). Cases with CNV may be confused with occult CNV in age-related macular degeneration. In our case, we will present the visual and anatomical results of a patient with AOVF-related CNV, in which we administered 3 doses of intravitreal ranibizumab (IVR). A 59-year-old female patient, who attended our clinic with the complaint of decreased vision in both eyes, was diagnosed with AOVF-related CNV in both eyes and was treated with 3 doses of IVR for 3 months. Despite the improvement in visual and anatomical functions 1 month after the first dose, vision decreased, and anatomical functions regressed to the pre-injection state in continued injections. IVR therapy is not an appropriate treatment option in the treatment of AOVF-associated CNV.

Successful management of rubella retinopathy–related subretinal neovascular membrane with intravitreal ranibizumab

A seven-year-old boy with a known case of bilateral rubella retinopathy presented to us as part of his annual follow-up. Best-corrected visual acuity (BCVA) at presentation was 20/80 in the right eye and 20/600 in the left eye. On dilated fundoscopy, the right eye showed the presence of subretinal neovascular membrane (SRNVM), subretinal fluid, and classical salt-and-pepper retinopathy, all of which was documented by imaging. The left eye was poorly dilating and showed a pale disc. The right eye was treated with two doses of intravitreal ranibizumab at an interval of two months. Post-treatment examination showed resolution of SRNVM accompanied by scarring and significant improvement in BCVA.

Short-term impact of glycaemic control and intravitreal ranibizumab treatment on serum cytokine levels and diabetic macular edema in patients with unregulated blood glucose

Objective: To evaluate the short-term effect of glycaemic control and intravitreal ranibizumab treatment on diabetic macular edema (DME) and to assess the correlation between HbA1c and certain serum cytokines. Design: A prospective study of 43 participants with HbA1c levels exceeding 53 mmol/mol (7%) and with DME, as detected by spectral domain optical coherence tomography (SDOCT). Subjects: Participants were grouped according to their initial best corrected distance visual acuity (BCVA). Group 1 was treated with three monthly doses of intravitreal ranibizumab (0.5 mg) injections, and Group 2 was followed without treatment. Methods: Serum cytokine levels, including interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1(MCP-1), and vascular endothelial growth factor (VEGF) were analysed at the beginning and at the end of 3 months, using enzyme-linked immunosorbent assays (ELISA). Results: A significant decrease in macular thicknesses (except for one quadrant) was observed in Group. Changes in serum cytokine levels were not correlated with HbA1c decrease. Serum VEGF level was significantly increased in Group 1, despite the intravitreal treatment. Conclusion: Short-term glycaemic control alone had limited value in the treatment of DME. The therapeutic effect of intravitreal treatment on DME supports the role of the local cytokine milieu in the pathophysiology.

Appropriate dose of intravitreal ranibizumab for ROP: a retrospective study

ObjectiveTo compare the recurrence rate of retinopathy of prematurity (ROP) after treatment with 0.3 mg vs. 0.25 mg ranibizumab.SubjectsAll patients with ROP who underwent intravitreal injection of ranibizumab in Hainan General Hospital between January 2014 and May 2020 were included in this retrospective study.MethodsEighty-two cases (146 eyes) who received intravitreal injection of 0.25 mg ranibizumab were included in the conventional-dose group, and 59 cases (108 eyes) who received intravitreal injection of 0.3 mg ranibizumab were included in the high-dose group. The two groups were further divided into the 25-28-week, 29-31-week, 32-34-week, and 35-36-week GA subgroups. The differences between the conventional-dose group and the high-dose group in gestational age (GA), birth weight (BW), age at initial injection (weeks), incidence of systemic diseases, the recurrence rate of ROP, and age at retinal vascularization completed (weeks) were analyzed.ResultsGA, BW, age at initial injection, and the incidence of systemic diseases were not significantly different between the conventional-dose group and the high-dose group (p > 0.05). The recurrence rates of ROP were significantly lower in the 25-28-week, 29-31-week, and 32-34-week subgroups of the high-dose group than in the same subgroups of the conventional-dose group (p < 0.05). Within the conventional-dose group, the recurrence rate of ROP was significantly lower in the 32-34-week and 35-36-week subgroups than in the 25-28-week and 29-31-week subgroups (p < 0.05). Within the high-dose group, the recurrence rate of ROP was not significantly different between the four subgroups (p > 0.05). Retinal vascularization was completed at a later age in the 32-34-week subgroup of the high-dose group than in the 32-34-week subgroup of the conventional-dose group (p < 0.05) but was not significantly different between the two groups at any other GA range (p > 0.05). No severe ocular or systemic complications occurred in any patient.ConclusionTreatment with 0.3 mg ranibizumab can reduce the recurrence rate of ROP without prolonging retinal vascularization or causing serious systemic complications. Therefore, this dose may be an appropriate therapeutic dose for ROP.

Comparison of Long-term Efficacy of Intravitreal Ranibizumab in Diabetic Retinopathy following Monthly vs Pro Re Nata vs Treat and Extend Protocol

Introduction: Diabetic Retinopathy (DR) is a major complication of Diabetes Mellitus (DM), which remains a leading cause of visual loss in working age populations. The most common cause of vision loss in patients with DR is Diabetic Macular Oedema (DME). Intravitreal administration of anti-Anti-Vascular Endothelial Growth Factor (anti-VEGF) agents is currently the mainstay of therapy for both early and advanced stages of DR. Aim: To compare long-term change in Central Macular Thickness (CMT) and Best Corrected Visual Acuity (BCVA) in patients with Non Proliferative Diabetic Retinopathy (NPDR) with Clinically Significant Macular Oedema (CSME) after receiving Intravitreal Ranibizumab (IVR) following monthly, Pro Re Nata (PRN) protocol and TreaT&amp;Extend (T&amp;E) protocol. Materials and Methods: This is a hospital based longitudinal prospective cohort study conducted on patients attending the Out Patient Department (OPD) of the Opthalmology Department at Midnapore Medical College &amp; Hospital West Bengal, India. from October 2018 to February 2021. Institutional Ethical clearance was obtained prior to the initiation of the study. Among 93 patients, 31 were chosen each for IVR PRN Monthly (Group A), (Group B) and T&amp;E protocol (Group C) over a period of nine months. CMT and BCVA were measured at baseline and followed up monthly for 12 months after last injection using Spectral Domain Optical Coherence Tomography (SD-OCT), while Glycated Haemoglobin (HbA1c) level was maintained below 7.4. Statistical analyses were performed using Statistical Package of Social Sciences (SPSS) statistics version 20 software. Chi-square test was used to find out the association between categorical variables. Pre and post comparisions were done using Wilcoxon sign rank test. A p-value less than 0.05 were considered as statistically significant. Results: There was significant decrease in CMT and betterment of BCVA in all groups at the end of treatment compared to baseline. At six months and one year of last injection there was no significant change in CMT in group A and C while group B at one year (p=0.0487) showed significant increase. There was no significant worsening of BCVA in group A and group C while group B (p=0.01) showed significant worsening at one year longterm follow-up. Conclusion: Thus, the present study concludes that, even though monthly protocol T&amp;E protocol are equally good compared to PRN protocol on the basis of long-term beneficial effect, T&amp;E protocol needed comparatively fewer doses of IVR compared to monthly protocol making it the choice of protocol for long-term control in NPDR with DME patients.

Evaluation of retinal inflammatory biomarkers after intravitreal steroid implant and Ranibizumab injection in diabetic macular edema

To compare the efficacy of intravitreal (IV) ranibizumab (IVR) injection with IV dexamethasone implant (IVDEX) in treatment naive diabetic macular edema (DME) patients with inflammatory component. Treatment naive DME eyes with subfoveal neurosensorial detachment (SND) and hyperreflective spots (HRS) were treated either three loading doses of IVR (18 eyes) or one dose of IVDEX (19 eyes). Central macular thickness (CMT), height of SND, the number of HRSs scattered on the individual retinal layers and photoreceptor integrity were assessed using spectral domain- optical coherence tomography scans over 3-months follow-up. The mean change in best-corrected visual acuity (BCVA) was -0.11 ± 0.08 logMAR in IVDEX group and -0.04 ± 0.06 logMAR in IVR group at 1-month (p = 0.011). IVDEX group showed statistically significant more increase in BCVA compared to those receiving IVR injections at 2-months (p = 0.004) and 3-months (p = 0.017) visits. Compared to baseline, the number of total HRSs and the number of HRSs at each individual inner retinal layer significantly decreased in both groups at all follow-up visits. However, IVDEX group showed more decrease in the total number of HRSs at 2- and 3-months (p < 0.001 at 2-months, and p = 0.006 at 3-months) and in the mean number of HRSs located at inner nuclear layer-outer plexiform layer level (p = 0.016 at 1-month, p < 0.001 at 2-months, and p < 0.001 at 3-months). After treatment, the number of HRSs on the outer nuclear layer showed some non-significant increase in both groups. HRSs tended to migrate from inner retina to the outer retina in DME eyes by treatment. Dexamethasone seemed to be more effective option in such cases with inflammatory component.

The prognostic role of optical coherence tomography in diabetic macular edema patients undergoing early dexamethasone implant shift.

To determine the prognostic characteristics of optical coherence tomography (OCT) parameters by evaluating diabetic macular edema (DME) patients with early dexamethasone (DEX) shift after three doses of intravitreal ranibizumab (RNB) injection. Fifty-four eyes of 34 patients who had DEX implant after three doses of RNB were included in this retrospective study. Early DEX shift includes patients who received direct DEX implant replacement after three doses of RNB load. Baseline OCT values and factors affecting best corrected visual acuity (BCVA) and central macular thickness (CMT) response were analyzed with logistic regression analyses. The presence of subretinal fluid and hyperreflective spot (HRS) >20 were found to be a negative predictive factor for anatomical response. (p = 0.009, p = 0.001, respectively) Low initial BCVA creates a positive effect on visual gain.( p = 0.041) Giant outer nuclear layer cysts, completely disrupted inner segment-outer segment and HRS > 20 have a negative effect on visual gain. (p = 0.025, p = 0.043, p = 0.023, respectively) According to the receiver operating characteristic analysis, the subretinal fluid volume threshold at which >20% reduction in CMT occurs was determined to be 0.85 mm3. (sensitivity 70%, specificity 84% area under the curve 0.817, p = 0.021). The presence of high number of HRS and high subretinal fluid volume at the baseline negatively affect prognosis even in patient groups with early DEX shift.

COMPARATIVE EFFICACY OF INTRAVITREAL RANIBIZUMAB MONOTHERAPY WITH COMBINED INTRAVITREAL RANIBIZUMAB AND LASER PHOTOCOAGULATION THERAPY IN THE MANAGEMENT OF DIABETIC MACULAR EDEMA.

Background: In this study, best corrected visual acuity and macular thickness were compared before and after intravitreal injection Ranibizumab monotherapy and combined therapy of injection Ranibizumab and laser, in patients with macular oedema ≥350µm measured with spectral domain OCT. Objective:Our specific objective is to identify the best treatment option in NPDR with macular thickness ≥350µm in Type 2 diabetic retinopathy patients depending upon the anatomical and functional outcome in each group. Method: Sixty (60) newly diagnosed eyes of NPDR with macular oedema (30 patients in each group) attending retina research clinic of Regional Institute of Ophthalmology,Kolkata were included in this study. Result: This parallel group comparison trial has shown that a combination of 3 consecutive monthly doses of intravitreal ranibizumab followed by modified grid laser therapy 7-10 days latter is more effective in reducing central macular thickness in comparison to only multiple injections of ranibizumab,but there is no difference in the final best corrected visual acuity attained in between the two groups. Conclusion: Laser photocoagulation along withanti-vascularendothelialgrowthfactoragentisthestrongerweapontofightagainstblindnessindiabeticmacularedema

Choroidal neovascular membrane associated with unilateral retinitis pigmentosa

Abstract A 67 year-old woman with diabetes mellitus type 2 no medical background of interest was attended in hospital due to visual loss of left eye of 4 months of onset. The fundus examination revealed findings corresponding to moderate non-proliferative diabetic retinopathy in the right eye and pigmented lesions similar to bone spicules and atrophy of the retinal pigment epithelium in the middle periphery and in the macular area in the left eye. The full-field electroretinogram was flat, with a slight insinuation of the b-wave in the light adaptation with a single flash of 3.0 cd in the left eye. The optical coherence tomography showed the atrophic retina in all its layers, as well as intraretinal cysts and a serous neurosensory detachment of the macular retina with a lesion of high reflectivity in the left eye. Infectious and inflammatory diseases were ruled out. Three doses of intravitreal ranibizumab were administered monthly. The presence of choroidal neovascular membrane associated with unilateral retinitis pigmentosa has not been previously reported. The patient improved with intravitreal ranibizumab.

Optical Coherence Tomography Patterns in Diabetic Macular Edema and Its Impact on Anatomical and Functional Outcome after Intravitreal Injection of Ranibizumab

Background: to report the anatomical and functional outcome based on patterns of optical coherence tomography (OCT) morphology in diabetic macular edema (DME), following treatment with intravitreal ranibizumab (IVR) injection. Aim of the Work: to evaluate the role of OCT in detecting the patterns of DME and its effect on anatomical and functional outcome after IVR injection. Patients and Methods: this study enrolled 30 eyes of patients with DME. These patients were categorized into 3 groups according to OCT finding, group I- 10 eyes with diffuse retinal thickening (DRT), group II- 10 eyes with cystoid macular edema (CME), group III- 01 eyes with neurosensory detachment (NSD). All patients received a three monthly doses of intravitreal ranibizumab. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were assessed before and after the treatment (in the 1st, 3rd and 6th month). Results: at month 6, mean BCVA changed with 0.24 ± 0.057 Decimal (P<0.001),0.23± 0.10 Decimal (P<0.001) and 0.11 ± 0.12 Decimal (P=0.019), respectively, for DRT, CME and NSD groups. Mean CMT decreased by119.80 ± 84.58μm (P=0.002) in DRT group, by83.00 ± 65.98μm (P=0.003) in CME group and by 102.30 ± 110.25 μm (P=0.017) in NSD group. The DRT group was associated with superior BCVA improvement and greater reduction in CMT. Conclusion: we found statistically significant improvement of BCVA and CMT in all groups of DME based on OCT pattern at final follow-up with greater reduction in CMT and superior BCVA improvement in DRT group.

Optical Coherence Tomography Patterns in Diabetic Macular Edema and Its Impact on Anatomical and Functional Outcome after Intravitreal Injection of Ranibizumab

Background: to report the anatomical and functional outcome based on patterns of optical coherence tomography (OCT) morphology in diabetic macular edema (DME), following treatment with intravitreal ranibizumab (IVR) injection. Aim of the Work: to evaluate the role of OCT in detecting the patterns of DME and its effect on anatomical and functional outcome after IVR injection. Patients and Methods: this study enrolled 30 eyes of patients with DME. These patients were categorized into 3 groups according to OCT finding, group I- 10 eyes with diffuse retinal thickening (DRT), group II- 10 eyes with cystoid macular edema (CME), group III- 01 eyes with neurosensory detachment (NSD). All patients received a three monthly doses of intravitreal ranibizumab. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were assessed before and after the treatment (in the 1st, 3rd and 6th month). Results: at month 6, mean BCVA changed with 0.24 ± 0.057 Decimal (P<0.001),0.23± 0.10 Decimal (P<0.001) and 0.11 ± 0.12 Decimal (P=0.019), respectively, for DRT, CME and NSD groups. Mean CMT decreased by119.80 ± 84.58μm (P=0.002) in DRT group, by83.00 ± 65.98μm (P=0.003) in CME group and by 102.30 ± 110.25 μm (P=0.017) in NSD group. The DRT group was associated with superior BCVA improvement and greater reduction in CMT. Conclusion: we found statistically significant improvement of BCVA and CMT in all groups of DME based on OCT pattern at final follow-up with greater reduction in CMT and superior BCVA improvement in DRT group.

Membrana neovascular coroidea asociada a retinitis pigmentosa unilateral

A 67 year-old woman with diabetes mellitus type 2 no medical background of interest was attended in hospital due to visual loss of left eye of 4 months of onset. The fundus examination revealed findings corresponding to moderate non-proliferative diabetic retinopathy in the right eye and pigmented lesions similar to bone spicules and atrophy of the retinal pigment epithelium in the middle periphery and in the macular area in the left eye. The full-field electroretinogram was flat, with a slight insinuation of the b-wave in the light adaptation with a single flash of 3.0cd in the left eye. The optical coherence tomography showed the atrophic retina in all its layers, as well as intraretinal cysts and a serous neurosensory detachment of the macular retina with a lesion of high reflectivity in the left eye. Infectious and inflammatory diseases were ruled out. Three doses of intravitreal ranibizumab were administered monthly.The presence of choroidal neovascular membrane associated with unilateral retinitis pigmentosa has not been previously reported. The patient improved with intravitreal ranibizumab.

Comparison of the effect of ranibizumab and dexamethasone implant on serous retinal detachment in diabetic macular edema

To compare the efficacy of intravitreal ranibizumab (IVR) and intravitreal dexamethasone implant (IDI) on neurosensory retinal detachment (SRD) associated with diabetic macular edema (DME) in the early treatment period. This was a retrospective, interventional, case-control study. After three monthly loading doses of IVR or an initial IDI injection, the changes in best-corrected visual acuity (BCVA), central macular thickness (CMT) on OCT, and presence and height of SRD were evaluated. The IVR and IDI groups consisted of 101 and 35 eyes, respectively. The mean changes in CMT in the IVR and IDI groups were 204.4±176.6 and 311.4±163, respectively (P<0.001). The mean changes in SRD height in the IVR and IDI groups were 133.6±92.1 and 168.6±103.9μm, respectively. The decrease in SRD height was significantly greater in the IDI group than in the IVR group (P=0.002). The SRD resolved completely in 72.2% and 71.4% of the patients in the IVR and IDI groups, respectively (P=0.9). The mean reduction in CMT and SRD height was greater in the IDI group than in the IVR group. There was a negative correlation between baseline best-corrected visual acuity (BCVA) and SRD height and also between BCVA and CMT.

Analysis of the Recurrence of Plus Disease after Intravitreal Ranibizumab as a Primary Monotherapy for Severe Retinopathy of Prematurity

To assess the outcomes of severe retinopathy of prematurity (ROP) in zone I or posterior zone II, and of aggressive posterior ROP treated with a single dose of intravitreal ranibizumab (IVR) as monotherapy. Retrospective study. The study included premature babies diagnosed with aggressive posterior ROP or ROP 3+ in zone I or posterior zone II. Intravitreal injection of 0.25 mg (0.025 mL) ranibizumab was performed in the operating room. A disposable 1-mL syringe with a 30-gauge needle was used. Favorable outcome was considered regression of ROP after treatment (meaning regression of the retinal neovascularization and plus disease). Unfavorable outcome was progression to stages 4 and 5 of ROP. The study included 43 infants (85 eyes). The mean birth weight and gestational age were 1276±302 g and 29.7±2.0 weeks, respectively. The mean postmenstrual age at ROP diagnosis was 36±2.7 weeks and at treatment was 37.2±2.2 weeks. All 85 eyes demonstrated total regression of plus disease after a single dose of IVR. Twelve infants (29.2%) developed full vascularization of the peripheral retina in both eyes. Twenty-two infants (43 eyes [53.6%]) developed ROP reactivation at a mean interval of 7.1±3 weeks (range, 3-15 weeks) after IVR and needed rescue laser treatment of the peripheral avascular retina. The mean postmenstrual age at rescue laser was 43±3.2 weeks (range, 35.5-54.5 weeks). Six patients (11.6%) had persistent peripheral avascular retina in zone II for >6 months (or 24 weeks) after IVR treatment. Although there was complete regression of plus disease in all treated eyes, only 29.2% of the patients reached complete peripheral retinal vascularization. There was a disease reactivation in 53.6% of the patients and they needed additional laser therapy. The results of IVR treatment in severe ROP, even when initial control of the disease was achieved, did not eliminate the risk of late reactivation of the disease by retinal neovascularization. Some of the treated patients may achieve a permanent interruption in the development of the peripheral retinal vascularization.

Comparison of clinical efficacy between intravitreal injection of ranibizumab combined with grid laser photocoagulation versus laser photocoagulation alone for macular edema

Objective To compare the efficacy of combination therapy of single intravitreal injection of ranibizumab with grid laser photocoagulation and only laser photocoagulation for the treatment of macular edema due to branch retinal vein occlusion (BRVO). Methods Forty eyes of 40 patients with BRVO of at least 8 weeks duration were divided randomly into two groups. Group 1 with 20 eyes received grid laser photocoagulation alone; Group 2 with 20 eyes received a single dose of intravitreal ranibizumab followed by grid laser photocoagulation. Outcomes at 1, 3, 6 and 12 months follow-up were reported. Data were collected on best corrected visual acuity (BCVA), and central macular thickness (CMT). Results BCVA in group 1 compared with baseline vision showed no statistically significant difference at 1, 3, 6 and 12 months after treatment (t=0.105, 0.445, 0.944, 0.564, P>0.05). However, BCVA in group 2 compared with baseline showed statistically significant difference at all the follow-up time (t=4.684, 4.675, 3.823, 3.616, P<0.05). At the 12-month follow-up, vision improvement ≥0.3 logMAR was observed in 5 (25%, 5/20) eyes in group 1, while 13 eyes (65%) in group 2(χ2=6.46, P=0.01). At 1, 3, 6 and 12 months, there were statistically significant differences in the mean CMT of two groups (P<0.05). At 12 months, the CMT of two groups were decreased by (230.4±107.6)μm in Group 1, (336.2±167.5)μm in Group 2 from baseline respectively. Conclusion Combination therapy of single intravitreal injection of ranibizumab with grid laser photocoagulation for the treatment of macular edema due to BRVO was effective and safe, which would produce better results than grid laser photocoagulation alone. Key words: Ranibizumab, intravitreal injection; Grid laser photocoagulation; Macular edema; Branch retinal vein occlusion

Single intravitreal ranibizumab injection for optic disc neovascularisation due to possibly traumatic, direct carotid cavernous fistula

We report a patient with optic disc neovasculariation due to possibly traumatic direct carotid cavernous fistula treated by a single dose of intravitreal ranibizumab prior to neurointervention. A 25‐year‐old man had a 10‐month history of bilateral proptosis and left sixth nerve paralysis was evaluated. Conjunctival vessels were markedly dilated, especially in the left eye. Clinical examination and fundus fluorescein angiography revealed disc neovascularisation in the left eye with subtle peripheral retinal ischaemia. Magnetic resonance imaging suggested a high‐flow carotid cavernous fistula on the left side and this was confirmed by catheter angiography. A single dose of intravitreal ranibizumab was injected prior to neuro‐intervention. The disc neovascularisation regressed completely three days later. The left direct carotid cavernous fistula was later treated successfully with coil embolisation. Optic disc neovascularisation is a very rare feature of carotid cavernous fistula and intravitreal ranibizumab may be a useful therapeutic adjunct prior to neuro‐interventional techniques to reduce neovascularisation‐induced haemorrhage following the intervention.

OHP-017 Cost Comparison of Intravitreal Antiangiogenic Drugs in the Treatment of Age-Related Macular Degeneration

BackgroundThe primary treatment of Age-related Macular Degeneration (AMD) is based on inhibition of Vascular Epithelial Growth Factor (VEGF) with antiangiogenic drugs, which delay disease progression and improve the patient’s vision.Choosing...

Intravitreal bevacizumab and ranibizumab for choroidal neovascularization secondary to endogenous endophthalmitis.

To report two patients with endogenous endophthalmitis complicated by choroidal neovascularization managed with intravitreal bevacizumab (Avastin, Genentech, Inc., South San Francisco, CA) or ranibizumab (Lucentis, Genentech, Inc., South San Francisco, CA) and their respective outcomes. Retrospective chart review of 2 patients, one a 54-year-old diabetic woman on chemotherapy for pemphigus vulgaris and the other a 77-year-old diabetic male with cellulitis, who were treated for endogenous endophthalmitis complicated by choroidal neovascularization. The patients were managed with off-label intravitreal anti-vascular endothelial growth factor injections. The first patient received one dose of intravitreal bevacizumab (Avastin) with improvement in vision and anatomy. The second patient received four doses of intravitreal ranibizumab (Lucentis) with improvement in vision and structural appearance. Choroidal neovascularization secondary to endogenous endophthalmitis responds to anti-vascular endothelial growth factor therapy with bevacizumab or ranibizumab.

Time Course of Morphologic Effects on Different Retinal Compartments after Ranibizumab Therapy in Age-related Macular Degeneration

To analyze the effect of ranibizumab therapy on retinal and subretinal compartments in age-related macular degeneration and to compare the time course of compartment specific effects to visual function. Prospective noncomparative case series. Fourteen patients with changes in 3 major compartments owing to neovascular age-related macular degeneration. Standard treatment with 3 monthly doses of intravitreal ranibizumab was performed. Eyes were examined at baseline and weeks 1, 4, and 12 using a standardized protocol. Manual segmentation was applied to all 128 B-scans contained in a macular raster scan (MRS). Morphology and time course of different retinal and subretinal compartments. High-definition optical coherence tomography and manual segmentation allowed for precise identification of volumes within individual compartments. All morphologic parameters responded positively to therapy, but demonstrated a specific time course. Subretinal fluid was identified as the most relevant factor for visual function, whereas changes in retinal and subpigment epithelial volumes did not correlate with the time course of functional rehabilitation. Analysis of MRS identified a characteristic impact of therapy on retinal and subretinal morphology.