PMID- 25205618
OWN - NLM
STAT- MEDLINE
DCOM- 20160329
LR  - 20211021
IS  - 1435-702X (Electronic)
IS  - 0721-832X (Linking)
VI  - 253
IP  - 8
DP  - 2015 Aug
TI  - Intravitreal Ranibizumab for neovascular Age-related macular degeneration in 
      clinical practice: five-year treatment outcomes.
PG  - 1217-25
LID - 10.1007/s00417-014-2799-8 [doi]
AB  - BACKGROUND: Intravitreal anti-vascular endothelial growth factor (anti-VEGF) 
      agents are the established standard of care for neovascular age-related macular 
      degeneration (nAMD). However, data on long-term outcomes of this therapy are 
      limited. The purpose of this study was to assess the visual and anatomical 
      outcomes and safety profile of intravitreal ranibizumab in treating nAMD over a 
      period of five years. METHODS: 208 patients (208 eyes) were included in this 
      retrospective case series study. Intervention was an "as-needed" treatment model. 
      Visual acuity (VA), central macular thickness (CMT), ophthalmic examination, and 
      adverse events (AEs) were assessed in each visit. Snellen VA was converted to 
      Early Treatment Diabetic Retinopathy Study letters for analysis. RESULTS: The 
      average VA improved by 1.9 letters after one year (p = 0.017), and decreased by 
      2.4 letters over five years of treatment (p = 0.043). At the end of year five, 
      11.1 % of patients (23/208) had improved VA by more than 15 letters and 68.8 % 
      (143/208) had VA improvement or loss less than or equal to 15 letters, while 20.2 
      % of patients (42/208) had a loss of more than 15 letters. Patients with VA of 
      less than 35 letters at baseline showed significant VA improvement after five 
      years of treatment. There was a positive relationship between injection numbers 
      and VA improvement over the five-year period, after adjusting for age and 
      baseline VA (p < 0.0005). Mean CMT decreased by 28.3 mum (p < 0.0005) over five 
      years. Ocular AEs, serious adverse events (SAEs), and systemic SAEs occurred in 
      4.6 %, 0.48 %, and 2 % of patients, respectively, during the follow-up period. 
      CONCLUSIONS: The use of intravitreal ranibizumab in an as-needed treatment 
      regimen over a five-year period was effective in maintaining vision in patients 
      with nAMD and in reducing macular thickness, with a relatively low rate of 
      adverse and serious adverse events.
FAU - Zhu, Meidong
AU  - Zhu M
AD  - Sydney Institute of Vision Science, Level 13, 187 Macquarie Street, Sydney, 2000, 
      Australia.
FAU - Chew, Jamie K
AU  - Chew JK
FAU - Broadhead, Geoffrey K
AU  - Broadhead GK
FAU - Luo, Kehui
AU  - Luo K
FAU - Joachim, Nichole
AU  - Joachim N
FAU - Hong, Thomas
AU  - Hong T
FAU - Syed, Adil
AU  - Syed A
FAU - Chang, Andrew A
AU  - Chang AA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140910
PL  - Germany
TA  - Graefes Arch Clin Exp Ophthalmol
JT  - Graefe's archive for clinical and experimental ophthalmology = Albrecht von 
      Graefes Archiv fur klinische und experimentelle Ophthalmologie
JID - 8205248
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (VEGFA protein, human)
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - ZL1R02VT79 (Ranibizumab)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiogenesis Inhibitors/adverse effects/*therapeutic use
MH  - Female
MH  - Fluorescein Angiography
MH  - Follow-Up Studies
MH  - Humans
MH  - Intravitreal Injections
MH  - Male
MH  - Ranibizumab/adverse effects/*therapeutic use
MH  - Retina/pathology
MH  - Retrospective Studies
MH  - Subretinal Fluid/physiology
MH  - Tomography, Optical Coherence
MH  - Treatment Outcome
MH  - Vascular Endothelial Growth Factor A/antagonists & inhibitors
MH  - Visual Acuity/drug effects
MH  - Wet Macular Degeneration/diagnosis/*drug therapy
EDAT- 2014/09/11 06:00
MHDA- 2016/03/30 06:00
CRDT- 2014/09/11 06:00
PHST- 2014/04/19 00:00 [received]
PHST- 2014/08/07 00:00 [accepted]
PHST- 2014/07/09 00:00 [revised]
PHST- 2014/09/11 06:00 [entrez]
PHST- 2014/09/11 06:00 [pubmed]
PHST- 2016/03/30 06:00 [medline]
AID - 10.1007/s00417-014-2799-8 [doi]
PST - ppublish
SO  - Graefes Arch Clin Exp Ophthalmol. 2015 Aug;253(8):1217-25. doi: 
      10.1007/s00417-014-2799-8. Epub 2014 Sep 10.