scholarly journals Clinical Features, Prognosis, and Long-Term Response to Ranibizumab of Macular CNVs in Pattern Dystrophies Spectrum: A Pilot Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Lorenzo Casillo ◽  
Stefano Tricarico ◽  
Laura Contento ◽  
Enzo M. Vingolo
Keyword(s):  
Choroidal Thickness ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Intravitreal Ranibizumab ◽  
Evolutionary Mechanisms ◽  
Age Related ◽  
Functional Features ◽  
Long Term Prognosis ◽  
Term Response

Introduction. To analyze the morphological and functional features of choroidal neovascularizations (CNVs) in eyes affected by pattern dystrophies (PD), evaluating their long-term response to intravitreal ranibizumab, and comparing them with CNVs in age-related macular degeneration (AMD). The mean goal is to identify possible disease biomarkers and to evaluate the long-term prognosis of CNVs in PD. Materials and Methods. A retrospective study of 42 patients with naïve CNV (26 PD and 16 AMD), for a total of 47 eyes (29 eyes in the PD group and 18 eyes in the AMD group). Each patient received a loading dose of ranibizumab (one monthly for three months) followed by pro re nata (PRN) reinjection protocol for a period of at least three years. Morphological OCT parameters (CRT, central retinal thickness; SRF, subretinal fluid; IRF, intraretinal fluid; SHRM, subretinal hyperreflective material; HRF, hyperreflective foci; HCD, hyperreflective crystalline deposits; cCT, central choroidal thickness; slCT, sublesional choroidal thickness; EZd, ellipsoid zone disruption; and best corrected visual acuity (BCVA in logMAR scale)) were reported at baseline and last follow-up. Results. At baseline, no significant differences were found between the two groups, except for choroidal thickness parameters that were significantly greater in the PD group ( p  = 0.009). Longitudinal PD analysis demonstrated reduction in BCVA ( p  = 0.009), decrease in CRT ( p  = 0.046), resolution of SRF in 61.6% of cases ( p  = 0.004) and SHRM in 30% ( p  = 0.034), and choroidal thinning both centrally ( p  = 0.004) and sublesional ( p  = 0.011) compared to baseline. At 3 years, the PD group received significantly more injections than the AMD ( p  = 0.011) and showed significantly thicker choroid ( p  = 0.033) and more frequent HRF ( p  = 0.006). Regarding the PD group, we found a negative correlation between age and choroidal thicknesses at baseline and at 3 years ( p  < 0.05); significant positive correlations were found between baseline BCVA and at 3 years ( p  < 0.001), BCVA at 3 years and IRF ( p  = 0.003) and SHRM at 3 years ( p  = 0.003); CRT baseline and CRT 3 years ( p  = 0.017); HCD at 3 years was associated with greater CRT ( p  = 0.04) and IRF at 3 years ( p  = 0.019). Conclusions. Early and long-term morphofunctional features of CNVs in PD and in AMD are overlapping. CNVs in PD have poorer long-term response to ranibizumab and higher choroidal thickness suggesting different pathogenetic and evolutionary mechanisms.

scholarly journals Short-Term Outcomes following “Switching” to Monthly Ranibizumab in Neovascular Age-Related Macular Degeneration Showing Insufficient Response to Bimonthly Aflibercept

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jong Suk Lee ◽  
Hyun Goo Kang ◽  
Christopher Seungkyu Lee ◽  
Se Joon Woo
Keyword(s):  
Macular Degeneration ◽  
Subretinal Fluid ◽  
Retrospective Chart Review ◽  
Age Related Macular Degeneration ◽  
Intravitreal Ranibizumab ◽  
Age Related ◽  
Intraretinal Fluid ◽  
Insufficient Response ◽  
Healthcare Insurance ◽  
Injection Interval

Background/Objectives. To evaluate the efficacy of switching to monthly ranibizumab in neovascular age-related macular degeneration (nAMD) showing an insufficient response to bimonthly aflibercept. Subjects/Methods. A total of 13 nAMD eyes showing an insufficient treatment response to three successive aflibercept injections were enrolled through a retrospective chart review. After switching, three consecutive monthly intravitreal ranibizumab injections were performed. The main outcome measurements included the best-corrected visual acuity (BCVA), central retinal thickness (CRT), presence of intraretinal fluid (IRF), and subretinal fluid (SRF) using optical coherence tomography (OCT) and were measured every month. Results. CRT and logMAR VA were 349.62 ± 223.51 μm and 0.50 ± 0.23 at the baseline and 274.69 ± 148.77 μm and 0.46 ± 0.24, 311.54 ± 192.90 μm and 0.45 ± 0.20 at 1 month after the first and third ranibizumab injections, respectively. The CRT decrease during three ranibizumab injections was statistically significant (38.08 ± 69.52 μm, p = 0.033 ). Change in VA was not statistically significant. The percentage of eyes with SRF was 100% at baseline and 53.8%, 76.9%, and 69.2% one month after each ranibizumab injections. The percentage of eyes with IRF was 38.5% at baseline and 23.1%, 23.1%, and 15.4%, respectively, after switching. Conclusion. Switching to monthly ranibizumab in nAMD showing an insufficient response to bimonthly aflibercept led to immediate anatomical improvement. It can be considered in countries where the healthcare insurance system limits the minimum injection interval of aflibercept.

scholarly journals Long term intravitreal ranibizumab treatment for exsudative age-related macular degeneration

2013 ◽  
Vol 154 (45) ◽  
pp. 1790-1797 ◽  
Author(s):  
Regina Lukács ◽  
Miklós Resch ◽  
András Papp ◽  
Antal Szabó ◽  
Ágnes Borbándy ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Retinal Thickness ◽  
Age Related Macular Degeneration ◽  
Central Retinal Thickness ◽  
First Year ◽  
Intravitreal Ranibizumab ◽  
Age Related ◽  
Pro Re Nata ◽  
Ranibizumab Treatment

Introduction: The results of intravitreal ranibizumab treatment for exsudative age-related macular degeneration have been favourable until this time. Aim: To evaluate the two-year functional and anatomic results of intravitreal ranibizumab treatment. Method: 46 patients (age: 75±9.1 years) were included in a prospective single center study. Treatment regimen was the following: monthly 0.5 mg ranibizumab was administered in the first 3 months, and later as required (pro re nata). The change of best corrected visual acuity and central retinal thickness was followed. Results: The visus change at the end of the follow-up time was not statistically significant compared to baseline (p = 0.760) and the at the end of the first year (p = 0.154). Central retinal thickness decreased significantly compared to baseline (p = 0.000001), but the change was not statistically significant compared to the end of the first year (p = 0.875). Conclusions: Patients with neovascular macular degeneration treated with intravitreal ranibizumab using pro re nata regimen have stable visus for long term, and the exsudation could be reduced efficiently. Orv. Hetil., 154(45), 1790–1797.

scholarly journals The Presence of Intra- or Subretinal Fluid during the Loading Phase in the Treatment of Exudative Age-Related Macular Degeneration with Intravitreal Ranibizumab Assessed by Optical Coherence Tomography

2015 ◽  
Vol 234 (2) ◽  
pp. 61-66
Author(s):  
Andreas Ebneter ◽  
Boris Gekkiev ◽  
Bhuvan Chanana ◽  
Sebastian Wolf ◽  
Martin S. Zinkernagel
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Degeneration ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Intravitreal Ranibizumab ◽  
Visual Improvement ◽  
Age Related ◽  
Treatment Naïve

Purpose: To assess intra- and subretinal fluid during the loading phase with intravitreal ranibizumab in exudative age-related macular degeneration and to quantify the accuracy of crosshair scan spectral-domain optical coherence tomography with regard to retinal fluid. Methods: This is a retrospective study of 31 treatment-naive patients who received 3 monthly intravitreal ranibizumab injections. Visual acuity and the presence of retinal fluid were assessed at each visit using volume and crosshair scan protocols. Results: Visual acuity improved and central retinal thickness decreased significantly during the loading phase. However, retinal fluid persisted in two thirds of the patients. The accuracy of the crosshair scan to detect fluid was 93%. Conclusions: A substantial proportion of eyes had persistent fluid after 3 months of ranibizumab injections. However, visual improvement was independent of residual fluid. Message: Crosshair scans detect relevant collections of retinal fluid accurately and may be sufficient in daily clinical practice.

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