Baseline characteristics and visual outcomes after two years follow-up of exudative age-related macular degeneration patients treated with ranibizumb_Chinese Journal of Ocular Fundus Diseases

Authors：

LianHaiyan ,  SongYanping , DingQin

Department of Ophthalmology, Wuhan General Hospital of Guangzhou Military, Wuhan 430070, China (Lian Haiyan, graduate student of Clinical Medical College of Southern Medical University);

Corresponding author：

SongYanping, Email: songyanping@medmail.com.cn

Keywords：

Choroidal neovascularization/drug therapy; Macular degeneration/drug therapy; Angiogenesis inhibitors/therapeutic use; Antibodies, monoclonal/therapeutic use

DOI：

10.3760/cma.j.issn.1005-1015.2017.01.011

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Objective To observe the baseline characteristics and visual outcomes after two years follow-up of exudative age-related macular degeneration (AMD) patients treated with ranibizumb. Methods Forty-four eyes of 44 patients with exudative AMD were enrolled into this retrospective study, 19 were men and 25 were women. The mean age was 78 years (range 64 – 92 years). All patients were underwent best corrected visual acuity (BCVA, Early Treatment of Diabetic Retinopathy Study), fundus color photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). The mean BCVA was (50.36±14.43) letters, the mean central foveal thickness (CFT) was (291.95±82.19) μm, and the fluorescence leakage area of choroidal neovascularization (CNV) was (7.61±5.84) mm². All patients received three initial intravitreous injection of ranibizumb (IVR) and were retreated with monthly IVR when needed. The mean follow up time was 25.6 months (range 24 – 29 months). On 1, 2, 3, 6, 12, 18 and 24 months after treatment, BCVA and OCT were repeated. On 3, 6, 12, 18 and 24 months after treatment, FFA and ICGA were repeated. The change of BCVA, CFT and fluorescence leakage area of CNV were observed. The association of baseline characteristics and two year visual outcomes were analyzed. Results On 1, 2, 3, 6, 12, 18 and 24 months after treatment, the BCVA were improved significantly (t= −1.89, −3.51, −4.61, −4.04, −5.77, −4.69;P＜0.05), the CFT were decreased significantly (t=1.51, 2.30, 3.40, 3.28, 3.54, 3.88, 3.73;P＜0.05). On 3, 6, 12, 18 and 24 months after treatment, the fluorescence leakage area of CNV were reduced significantly (t=2.12, 2.90, 3.51, 4.12, 4.06;P＜0.05). The lower baseline BCVA, the more improved after treatment. The BCVA improvement degree has a negative relationship with baseline BCVA and fluorescence leakage area of CNV (r=0.505, −0.550;P＜0.05), but no correlation with baseline CFT (r=0.210,P＞0.05). Conclusion Two year visual outcomes of exudative AMD patients treated with ranibizumb is negative correlated with baseline BCVA and fluorescence leakage area of CNV, but not correlated with baseline CFT.

Citation： LIANHai-Yan, SONGYan-Ping, DINGQIN. Baseline characteristics and visual outcomes after two years follow-up of exudative age-related macular degeneration patients treated with ranibizumb. Chinese Journal of Ocular Fundus Diseases, 2017, 33(1): 40-43. doi: 10.3760/cma.j.issn.1005-1015.2017.01.011 Copy

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1. Rosenfeld PJ, Brown DM, Heier JS, et al. Ranibizumab for neovascular age-related macular degeneration[J]. N Engl J Med, 2006, 355(14): 1419-1431.
2. Brown DM, Kaiser PK, Michels M, et al.Ranibizumab versus verteporfin for neovascular age-related macular degeneration[J]. N Engl J Med, 2006, 355(14): 1432-1444.
3. Costanzo E, Miere A, Querques G, et al. Type 1 choroidal neovascularization lesion size: indocyanine green angiography versus optical coherence tomography angiography[J]. Invest Ophthalmol Vis Sci, 2016, 57(9): 307-313. DOI: 10.1167/iovs.15-18830.
4. Mehta S. Age-related macular degeneration[J]. Prim Care, 2015,42(3):377-391. DOI: 10.1016/j.pop. 2015.05.009.
5. Razi F, Haq A, Tonne P, et al. Three-year follow-up of ranibizumab treatment of wet age-related macular degeneration: influence of baseline visual acuity and injection frequency on visual outcomes[J]. Clin Ophthalmol, 2016, 10:313-319. DOI:10.2147/OPTH.S97775.
6. Williams TA, Blyth CP. Outcome of ranibizumab treatment in neovascular age related macula degeneration in eyes with baseline visual acuity better than 6/12[J]. Eye (Lond), 2011, 25(12): 1617-1621. DOI: 10.1038/eye.2011.224.
7. Shah AR, Priore LVD. Natural history of predominantly classic, minimally classic, and occult subgroups in exudative age-related macular degeneration[J]. Ophthalmology, 2009, 116(10):1901-1907. DOI: 10.1016/j.ophtha.2009.03.055.
8. Boyer DS, Antoszyk AN, Awh CC, et al. Subgroup analysis of the MARINA Study of ranibizumab in neovascular age-related macular degeneration[J]. Ophthalmology, 2007, 114(2): 246-252. DOI: 10.1016/j.ophtha.2006.10.045.
9. Rosenfeld PJ, Shapiro H, Tuomi L, et al. Characteristics of patients losing vision after 2 years of monthly dosing in the phase Ⅲ ranibizumab clinical trials[J]. Ophthalmology, 2011, 118(3): 523-530. DOI:10.1016/j.ophtha.2010.07.011.
10. Lalwani GA, Rosenfeld PJ, Fung AE, et al. A variable-dosing regimen with intravitreal ranibizumab for neovascular age-related macular degeneration: year 2 of the PrONTO Study[J]. Am J Ophthalmol 2009, 148(1):43-58. DOI: 10.1016/j.ajo.2009.01.024.

Chinese Journal of Ocular Fundus Diseases

Baseline characteristics and visual outcomes after two years follow-up of exudative age-related macular degeneration patients treated with ranibizumb

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