| Results of flexible ranibizumab treatment in age-related macular degeneration and search for parameters with impact on outcome. | |
| | |
MedLine Citation:
|
PMID: 21387180 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: The aim of this study was to analyse functional results of flexible ranibizumab treatment in exudative age-related macular degeneration (AMD), and to search for parameters with impact on outcome. METHODS: Analysis of a retrospective institutional case series (104 eyes) with a low-threshold re-treatment algorithm and monthly follow-up for 12 months. RESULTS: Visual acuity (VA) improved at month 3 by +6.7 letters and declined slightly until month 12 to a level of +5.0 letters. On average, eyes received 5.8 injections. A significant loss in VA occurred in the whole group between months 5 and 6 (-2.0 letters), never in the "winner" group (improvement of >5 letters at month 12), between months 5 and 6 (-3.8 letters) in the "stabilizer" group (∆ of ±5 letters at month 12) and twice, between months 3 and 7 (-7.0 letters) and months 9 and 12 (-6.9 letters), in the "loser" group (loss of >5 letters at month 12). These major functional declines followed moderate but significant increases in average CFT (OCT-central foveal thickness) of 23 to 33 μm. Increased CFT followed periods with a low percentage of treated eyes per month in each group. The amount of regained vision was significantly related to the extent of previous functional loss. The critical limit of short-term VA decline that was associated with the possibility for full VA restoration can approximately be quantified at -4 letters. Restoration of short-term VA deterioration (last month) was significantly better than long-term VA loss (related to the end of loading phase). Restoration of VA loss stratifies mainly into two groups: a group that regained -25 to 25% and one that regained 75 to 125%. A significant correlation was found between the number of injections and functional outcome at month 12 for eyes receiving more than four injections. It was calculated that a mean of 8.4 injections per eye would have been necessary to stabilize vision within the first 12 months. CONCLUSIONS: CFT is a sensitive and early predictor of VA deterioration. Four letters of acute VA loss seems to be a critical limit. VA loss of ≥4 letters appears to be associated with incomplete recovery. Eyes with <1 line of gain at the end of the loading phase should be considered for continuation of treatment at months 3 and 4. According to our calculations an average number of 8.4 injections/eye seems to be necessary to maintain stabilization of vision in the first year of treatment. |
| | |
Authors:
|
Heinrich Gerding; Vlassios Loukopoulos; Juliane Riese; Lars Hefner; Melanie Timmermann |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-3-9 |
Journal Detail:
|
Title: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie Volume: - ISSN: 1435-702X ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
|
Created Date: 2011-3-9 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8205248 Medline TA: Graefes Arch Clin Exp Ophthalmol Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Department of Retinology, Klinik Pallas, Louis-Giroud-Str. 20, CH-4600, Olten, Switzerland, hgerding@klinik-pallas.ch. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Association of serum 25-hydroxyvitamin D (25-OHD) concentrations with maternal sex steroids and IGF-...
Next Document: Delineation of the translocation of colicin E7 across the inner membrane of Escherichia coli.