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Ranibizumab for exudative AMD in a clinical setting: differences between 2007 and 2010

  • Retinal Disorders
  • Published:
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Abstract

Background/purpose

Visual results of ranibizumab given pro re nata in clinical settings depend greatly from the achievement of the monthly follow-up. In 2007, a previous study performed in our tertiary care showed a mean visual gain of only + 0.7 ETDRS chart letters, probably because of insufficient number of follow-up visits and injections. We report a second retrospective study of patients whose eyes were treated in the same setting, and whose first injection was performed after April 1 2010. The aim was to check if the changes in the management of AMD patients between 2010 and 2007 achieved better visual results.

Method

One hundred and twenty-two patients (125 eyes) with exudative age-related macular degeneration (AMD) were included. Age, gender, side, type of CNV, VA measured on an ETDRS chart at baseline and at 52 ± 6 weeks, the number of IVT performed, and follow-up visits were recorded. The series was compared to our former series of the year 2007. Results are expressed as means ± standard deviation. Mann–Whitney’s non-parametric test was used to compare the statistical distribution of the parameters measured. Fisher’s exact test was used for 2 × 2 categorical variables, and the chi-square test for others.

Results

In the 2010 series, the mean visual gain was +6.0 ± 11.0 l (−35 to + 34). During this period, the eyes had 5.0 ± 1.8 IVT and 7.8 ± 1.4 follow-up visits. No correlation was found between the change in VA and gender, type of CNV, age, or the numbers of IVT and visits. There was a reverse correlation between baseline VA and VA changes (r = −0.413, p < 0.0001): i.e., the higher the VA at presentation, the smaller the gain. Comparison between 2010 and 2007 showed that in 2010, patients were older (82.2 ± 7.0 vs 78.3 ± 7.0 y, p < 0.0001), had a better baseline VA (60.6 ± 12.7 vs 56.1 ± 14.6 l, p = 0.0191) and, despite the reverse correlation between change in VA and VA at presentation, visual results were better: +6.0 ± 11.0 vs +0.7 ± 11.99 l, p = 0.0003. In 2010, eyes received more injections: 5.0 ± 1.8 vs 3.8 ± 1.4 in 2007, p < 0.0001. However, the series did not differ for the number of visits, gender, side or type of CNV.

Conclusions

In 2010, monotherapy with ranibizumab for exudative AMD achieved better visual results than in 2007 in our clinical setting, despite the treatment of older patients with better baseline VA. This is probably due to the greater number of IVT performed. Alternate strategies, such as “inject and extend” or maintenance therapy, may also account for the better visual results.

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References

  1. Ip MS, Scott IU, Brown GC, Brown MM, Ho AC, Huang SS, Recchia FM, American Academy of Ophthalmology (2008) Anti-vascular endothelial growth factor pharmacotherapy for age-related macular degeneration: a report by the American Academy of Ophthalmology. Ophthalmology 115:1837–1846

    Article  PubMed  Google Scholar 

  2. Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY, MARINA Study Group (2006) Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 355:1419–1431

    Article  PubMed  CAS  Google Scholar 

  3. Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S, ANCHOR Study Group (2006) Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med 355:1432–1444

    Article  PubMed  CAS  Google Scholar 

  4. Regillo CD, Brown DM, Abraham P, Yue H, Ianchulev T, Schneider S, Shams N (2008) Randomized, double-masked, sham-controlled trial of ranibizumab for neovascular age-related macular degeneration: PIER Study year 1. Am J Ophthalmol 145:239–248

    Article  PubMed  CAS  Google Scholar 

  5. Fung AE, Lalwani GA, Rosenfeld PJ, Dubovy SR, Michels S, Feuer WJ, Puliafito CA, Davis JL, Flynn HW Jr, Esquiabro M (2007) An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol 143:566–583

    Article  PubMed  CAS  Google Scholar 

  6. Cohen SY, Dubois L, Tadayoni R, Fajnkuchen F, Nghiem-Buffet S, Delahaye-Mazza C, Guiberteau B, Quentel G (2009) Results of one-year’s treatment with ranibizumab for exudative age-related macular degeneration in a clinical setting. Am J Ophthalmol 148:409–413

    Article  PubMed  CAS  Google Scholar 

  7. Dadgostar H, Ventura AA, Chung JY, Sharma S, Kaiser PK (2009) Evaluation of injection frequency and visual acuity outcomes for ranibizumab monotherapy in exudative age-related macular degeneration. Ophthalmology 116:1740–1747

    Article  PubMed  Google Scholar 

  8. Rothenbuehler SP, Waeber D, Brinkmann CK, Wolf S, Wolf-Schnurrbusch UE (2009) Effects of ranibizumab in patients with subfoveal choroidal neovascularization attributable to age-related macular degeneration. Am J Ophthalmol 147:831–837

    Article  PubMed  CAS  Google Scholar 

  9. Querques G, Azrya S, Martinelli D, Berboucha E, Feldman A, Pece A, Coscas G, Soubrane G, Souied EH (2010) Ranibizumab for exudative age-related macular degeneration: 24-month outcomes from a single-centre institutional setting. Br J Ophthalmol 94:292–296

    Article  PubMed  Google Scholar 

  10. Bandukwala T, Muni RH, Schwartz C, Eng KT, Kertes PJ (2010) Effectiveness of intravitreal ranibizumab for the treatment of neovascular age-related macular degeneration in a Canadian retina practice: a retrospective review. Can J Ophthalmol 45:590–595

    Article  PubMed  Google Scholar 

  11. Rotsos T, Patel PJ, Chen FK, Tufail A (2010) Initial clinical experience of ranibizumab therapy for neovascular age-related macular degeneration. Clin Ophthalmol 10:1271–1275

    Article  Google Scholar 

  12. Biarnés M, Monés J, Villalbí JR, Arias L (2011) As-needed treatment with ranibizumab 0.5 mg in patients with neovascular age-related macular degeneration. Eur J Ophthalmol 21:282–289

    Article  PubMed  Google Scholar 

  13. Bloch SB, la Cour M, Sander B, Hansen LK, Fuchs J, Lund-Andersen H, Larsen M (2013) Predictors of 1-year visual outcome in neovascular age-related macular degeneration following intravitreal ranibizumab treatment. Acta Ophthalmol 91:42–47

    Article  PubMed  CAS  Google Scholar 

  14. Gerding H, Loukopoulos V, Riese J, Hefner L, Timmermann M (2011) Results of flexible ranibizumab treatment in age-related macular degeneration and search for parameters with impact on outcome. Graefes Arch Clin Exp Ophthalmol 249:653–662

    Article  PubMed  CAS  Google Scholar 

  15. Arias L, Roman I, Masuet-Aumatell C, Rubio MJ, Caminal JM, Catala J, Pujol O (2011) One-year results of a flexible regimen with ranibizumab therapy in macular degeneration: relationship with the number of injections. Retina 31:1261–1267

    Article  PubMed  CAS  Google Scholar 

  16. Hjelmqvist L, Lindberg C, Kanulf P, Dahlgren H, Johansson I, Siewert A (2011) One-year outcomes using ranibizumab for neovascular age-related macular degeneration: results of a prospective and retrospective observational multicentre study. J Ophthalmol 2011:405724. Epub 2011 Nov 28

  17. Cohen SY, Mimoun G, Oubraham H, Zourdani A, Malbrel C, Quere S, Schneider V (2013) Changes in visual acuity in patients with wet age-related macular degeneration treated with intravitreal ranibizumab in daily clinical practice. The LUMIERE Study. Retina 33:474–481

    Article  PubMed  CAS  Google Scholar 

  18. Spaide RF (2007) Ranibizumab according to need: a treatment for age-related macular degeneration. Am J Ophthalmol 143:679–680

    Article  PubMed  Google Scholar 

  19. Spaide RF (2009) The as-needed treatment strategy for choroidal neovascularization: a feedback-based treatment system. Am J Ophthalmol 148:1–3

    Article  PubMed  Google Scholar 

  20. Engelbert M, Zweifel SA, Freund KB (2009) “Treat and extend” dosing of intravitreal antivascular endothelial growth factor therapy for type 3 neovascularization/retinal angiomatous proliferation. Retina 29:1424–1431

    Article  PubMed  Google Scholar 

  21. Engelbert M, Zweifel SA, Freund KB (2010) Long-term follow-up for type 1 (subretinal pigment epithelium) neovascularization using a modified “treat and extend” dosing regimen of intravitreal antivascular endothelial growth factor therapy. Retina 30:1368–1375

    Article  PubMed  Google Scholar 

  22. Gupta OP, Shienbaum G, Patel AH, Fecarotta C, Kaiser RS, Regillo CD (2010) A treat and extend regimen using ranibizumab for neovascular age-related macular degeneration: clinical and economic impact. Ophthalmology 117:2134–2140

    Article  PubMed  Google Scholar 

  23. Oubraham H, Cohen SY, Samimi S, Marotte D, Bouzaher I, Bonicel P, Fajnkuchen F, Tadayoni R (2011) Inject and extend dosing versus dosing as needed: a comparative retrospective study of ranibizumab in exudative age-related macular degeneration. Retina 31:26–30

    Article  PubMed  CAS  Google Scholar 

  24. Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group, Martin DF, Maguire MG, Fine SL, Ying GS, Jaffe GJ, Grunwald JE, Toth C, Redford M, Ferris FL III (2012) Ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration: two-year results. Ophthalmology 119:1388–1398

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Centre Ophtalmologique d’Imagerie et de Laser, 11 Rue Antoine Bourdelle, Paris, 75015, France

    Salomon Y. Cohen, Lise Dubois, Sandrine Ayrault, Pauline Dourmad, Corinne Delahaye-Mazza, Franck Fajnkuchen, Sylvia Nghiem-Buffet & Gabriel Quentel

  2. Department of Ophthalmology, University Paris Diderot, Sorbonne Paris Cité—APHP, Hôpital Lariboisière, Paris, France

    Salomon Y. Cohen & Ramin Tadayoni

Authors
  1. Salomon Y. Cohen
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  2. Lise Dubois
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  3. Sandrine Ayrault
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  4. Pauline Dourmad
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  5. Corinne Delahaye-Mazza
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  6. Franck Fajnkuchen
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  7. Sylvia Nghiem-Buffet
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  8. Gabriel Quentel
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  9. Ramin Tadayoni
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Correspondence to Salomon Y. Cohen.

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The authors have full control of all primary data, and they agree to allow Graefe's Archive for Clinical and Experimental Ophthalmology to review their data upon request.

Supported by CIL-ASSOC, Association for Education and Research, Centre Ophtalmologique d’Imagerie et de Laser, Paris, France.

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Cohen, S.Y., Dubois, L., Ayrault, S. et al. Ranibizumab for exudative AMD in a clinical setting: differences between 2007 and 2010. Graefes Arch Clin Exp Ophthalmol 251, 2499–2503 (2013). https://doi.org/10.1007/s00417-013-2338-z

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  • DOI: https://doi.org/10.1007/s00417-013-2338-z

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