Intravitreal ranibizumab for pigment epithelium detachment with subfoveal occult choroidal neovascularization: a prospective 24-month case series.

Abstract

PURPOSE:

To assess the effects of intravitreal ranibizumab injection in patients affected by pigment epithelial detachment associated with occult subfoveal choroidal neovascularization.

DESIGN:

Prospective, interventional case series.

METHODS:

PARTICIPANTS:

Forty eyes of 40 patients were considered for the purpose of the study. Consecutive patients were recruited for a 24-month study. All patients underwent a complete ophthalmic examination, including best-corrected visual acuity on Early Treatment Diabetic Retinopathy Study (ETDRS) charts. After a 3-monthly loading phase, further intravitreal ranibizumab injections were administered on the basis of detection of any type of fluid on optical coherence tomography.

PRIMARY OUTCOME MEASURES:

Changes in mean best-corrected visual acuity at 12 and 24 months and the proportion of eyes losing fewer than 15 letters (corresponding to 3 ETDRS lines) from baseline visual acuity.

SECONDARY OUTCOME MEASURES:

Changes in central macular thickness on optical coherence tomography and variation in mean area of the entire lesion.

RESULTS:

Forty patients were included. Mean best-corrected visual acuity decreased from 20/66 (58 ETDRS letters) to 20/83 (53 letters) at 12 months and 20/112 (489 ETDRS letters) at 24 months (P = .003). Eighty percent and 67.5% of eyes lost fewer than 3 lines at 12 and 24 months, respectively. Mean central macular thickness passed from 545 μm to 428 μm at 12 months and 426 μm at 24 months. Mean lesion area changed from 6826 μm(2) to 6312 μm(2) at 12 months and 6010 μm(2) at 24 months.

CONCLUSIONS:

The treatment of pigment epithelial detachment associated with occult subfoveal choroidal neovascularization with intravitreal ranibizumab injection after a 3-monthly loading phase and pro re nata strategy can lead to partial results over a 24-month follow-up. Further investigations are warranted to establish the best therapeutic approach to this disease.

• Authors: Maurizio Battaglia Parodi, Pierluigi Iacono, Alexandros Papayannis, Stelios Dimitrios Kontadakis, Marialucia Cascavilla, Luisa Pierro, Marco Gagliardi, Francesco Bandello
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 155 Issue 1 Pg. 103-108.e2 (Jan 2013) ISSN: 1879-1891 [Electronic] United States
• PMID: 23022164 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized
• Coloring Agents
• Indocyanine Green
• Ranibizumab

Topics

• Aged
• Angiogenesis Inhibitors (administration & dosage, therapeutic use)
• Antibodies, Monoclonal, Humanized (administration & dosage, therapeutic use)
• Choroidal Neovascularization (diagnosis, drug therapy, physiopathology)
• Coloring Agents
• Female
• Fluorescein Angiography
• Follow-Up Studies
• Fovea Centralis
• Humans
• Indocyanine Green
• Intravitreal Injections
• Male
• Prospective Studies
• Ranibizumab
• Retinal Detachment (diagnosis, drug therapy, physiopathology)
• Retinal Pigment Epithelium (pathology)
• Tomography, Optical Coherence
• Visual Acuity (physiology)