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BMC Ophthalmology
Published in: BMC Ophthalmology 1/2013

Open Access 01-12-2013 | Research article

Effectiveness of intravitreal ranibizumab in exudative age-related macular degeneration (AMD): comparison between typical neovascular AMD and polypoidal choroidal vasculopathy over a 1 year follow-up

Authors: Wataru Matsumiya, Shigeru Honda, Sentaro Kusuhara, Yasutomo Tsukahara, Akira Negi

Published in: BMC Ophthalmology | Issue 1/2013

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Abstract

Background

The effects of intravitreal ranibizumab (IVR) against exudative age-related macular degeneration (AMD) may be different associated with the lesion phenotype. This study was conducted to compare the outcomes of IVR between two different phenotypes of exudative AMD: typical neovascular AMD (tAMD) and polypoidal choroidal vasculopathy (PCV).

Methods

This is a retrospective cohort study of 54 eyes from 54 subfoveal exudative AMD patients (tAMD 24, PCV 30 eyes). Three consecutive IVR treatments (0.5 mg) were performed every month, followed by re-injections as needed. Change in the best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were then compared between the tAMD and PCV groups over 12 months of follow-up.

Results

The mean BCVA was significantly improved (-0.11 logMAR units) at month 3 after the initial IVR (p <0 .001, Wilcoxon signed-rank test), and was sustained up to 12 months in all AMD patients (p =0.02). In the subgroup analysis, the tAMD group showed a significant improvement in their mean BCVA (-0.06, -0.17, -0.15 and -0.16 logMAR units at 1, 3, 6 and 12 months, respectively), but there was only a slight but non-significant improvement in the PCV group. The improvement in the BCVA was significantly greater in the tAMD group than in the PCV group (p = 0.043, repeated measures ANOVA) over 12 months. Both phenotypes showed significant improvements in the CRT during 12 months after the initial IVR.

Conclusions

IVR is an effective therapy for tAMD and PCV in the BCVA improvement in Japanese patients over 12 months of follow-up. The phenotype of tAMD showed a significantly better outcome with IVR than PCV in terms of BCVA improvement.
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Literature
1.
Morris B, Imrie F, Armbrecht AM, Dhillon B: Age-related macular degeneration and recent developments: new hope for old eyes?. Postgrad Med J. 2007, 83: 301-307. 10.1136/pgmj.2006.052944.CrossRefPubMedPubMedCentral
2.
Hernandez-Pastor LJ, Ortega A, Garcia-Layana A, Giraldez J: Ranibizumab for neovascular age-related macular degeneration. Am J Health Syst Pharm. 2008, 65: 1805-1814. 10.2146/ajhp070342.CrossRefPubMed
3.
Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S, ANCHOR Study Group: Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006, 355: 1432-1444. 10.1056/NEJMoa062655.CrossRefPubMed
4.
Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY, MARINA Study Group: Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006, 355: 1419-1431. 10.1056/NEJMoa054481.CrossRefPubMed
5.
Tano Y, Ohji M, EXTEND-I Study Group: EXTEND-I: safety and efficacy of ranibizumab in Japanese patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration. Acta Ophthalmol. 2010, 88: 309-316. 10.1111/j.1755-3768.2009.01843.x.CrossRefPubMed
6.
Fung AE, Lalwani GA, Rosenfeld PJ, Dubovy SR, Michels S, Feuer WJ, Puliafito CA, Davis JL, Flynn HW, Esquiabro M: An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (lucentis) for neovascular Age-related macular degeneration. Am J Ophthalmol. 2007, 143: 566-583. 10.1016/j.ajo.2007.01.028.CrossRefPubMed
7.
Mitchell P, Korobelnik JF, Lanzetta P, Holz FG, Prünte C, Schmidt-Erfurth U, Tano Y, Wolf S: Ranibizumab (Lucentis) in neovascular age-related macular degeneration: evidence from clinical trials. Br J Ophthalmol. 2010, 94: 2-13. 10.1136/bjo.2009.159160.CrossRefPubMed
8.
Suzuki M, Gomi F, Sawa M, Tsujikawa M, Sakaguchi H: Bevacizumab treatment for choroidal neovascularization due to age-related macular degeneration in Japanese patients. Jpn J Ophthalmol. 2010, 54: 124-128. 10.1007/s10384-009-0775-3.CrossRefPubMed
9.
Maruko I, Iida T, Saito M, Nagayama D, Saito K: Clinical characteristics of exudative age-related macular degeneration in Japanese patients. Am J Ophthalmol. 2007, 144: 15-22. 10.1016/j.ajo.2007.03.047.CrossRefPubMed
10.
Gomi F, Sawa M, Sakaguchi H, Tsujikawa M, Oshima Y, Kamei M, Tano Y: Efficacy of intravitreal bevacizumab for polypoidal choroidal vasculopathy. Br J Ophthalmol. 2008, 92: 70-73. 10.1136/bjo.2007.122283.CrossRefPubMed
11.
Stangos AN, Gandhi JS, Nair-Sahni J, Heimann H, Pournaras CJ, Harding SP: Polypoidal choroidal vasculopathy masquerading as neovascular age-related macular degeneration refractory to ranibizumab. Am J Ophthalmol. 2010, 150: 666-673. 10.1016/j.ajo.2010.05.035.CrossRefPubMed
12.
Yamashiro K, Tomita K, Tsujikawa A, Nakata I, Akagi-Kurashige Y, Miyake M, Ooto S, Tamura H, Yoshimura N: Factors associated with the response of age-related macular degeneration to intravitreal ranibizumab treatment. Am J Ophthalmol. 2012, 154: 125-136. 10.1016/j.ajo.2012.01.010.CrossRefPubMed
13.
Matsumiya W, Honda S, Bessho H, Kusuhara S, Tsukahara Y, Negi A: Early responses to intravitreal ranibizumab in typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy. J Ophthalmol. 2011, 2011: 742020-PubMedPubMedCentral
14.
Martin DF, Maguire MG, Ying GS, Grunwald JE, Fine SL, Jaffe GJ, CATT Research Group: Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med. 2011, 364: 1897-1908.CrossRefPubMed
15.
Yannuzzi LA, Sorenson J, Spaide RF, Lipson B: Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina. 1990, 10: 1-8.CrossRefPubMed
16.
Yannuzzi LA, Ciardella A, Spaide RF, Rabb M, Freund KB, Orlock DA: The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy. Arch Ophthalmol. 1997, 115: 478-485. 10.1001/archopht.1997.01100150480005.CrossRefPubMed
17.
Uyama M, Matsubara T, Fukushima I, Matsunaga H, Iwashita K, Nagai Y, Takahashi K: Idiopathic polypoidal choroidal vasculopathy in Japanese patients. Arch Ophthalmol. 1999, 117: 1035-1042. 10.1001/archopht.117.8.1035.CrossRefPubMed
18.
Spaide RF, Yannuzzi LA, Slakter JS, Sorenson J, Orlach DA: Indocyanine green videoangiography of idiopathic polypoidal horoidal vasculopathy. Retina. 1995, 15: 100-110. 10.1097/00006982-199515020-00003.CrossRefPubMed
19.
Ciardella AP, Donsoff IM, Huang SJ, Costa DL, Yannuzzi LA: Polypoidal choroidal vasculopathy. Surv Ophthalmol. 2004, 49: 25-37. 10.1016/j.survophthal.2003.10.007.CrossRefPubMed
20.
Schmidt-Erfurth UM, Richard G, Augustin A, Aylward WG, Bandello F, Corcòstegui B, Cunha-Vaz J, Gaudric A, Leys A, Schlingemann RO, European Society for Retina Specialists’ Guidelines Committee (EURETINA): Guidance for the treatment of neovascular age-related macular degeneration. Acta Ophthalmol Scand. 2007, 85: 486-494. 10.1111/j.1755-3768.2007.00979.x.CrossRefPubMed
21.
Ip MS, Scott IU, Brown GC, Brown MM, Ho AC, Huang SS, Recchia FM, American Academy of Ophthalmology: Anti-vascular endothelial growth factor pharmacotherapy for age-related macular degeneration: a report by the American academy of ophthalmology. Ophthalmology. 2008, 115: 1837-1846. 10.1016/j.ophtha.2008.08.012.CrossRefPubMed
22.
Mekjavic PJ, Kraut A, Urbancic M, Lenassi E, Hawlina M: Efficacy of 12-month treatment of neovascular age-related macular degeneration with intravitreal bevacizumab based on individually determined injection strategies after three consecutive monthly injections. Acta Ophthalmol. 2011, 89: 647-653. 10.1111/j.1755-3768.2009.01740.x. vCrossRefPubMed
23.
Holz FG, Amoaku W, Donate J, Guymer RH, Kellner U, Schlingemann RO, Weichselberger A, Staurenghi G, SUSTAIN Study Group: Safety and efficacy of a flexible dosing regimen of ranibizumab in neovascular age-related macular degeneration: the SUSTAIN study. Ophthalmology. 2011, 118: 663-671. 10.1016/j.ophtha.2010.12.019.CrossRefPubMed
24.
Kang S, Roh YJ: One-year results of intravitreal ranibizumab for neovascular age-related macular degeneration and clinical responses of various subgroups. Jpn J Ophthalmol. 2009, 53: 389-395. 10.1007/s10384-009-0670-y.CrossRefPubMed
25.
Song MH, Ryu HW, Roh YJ: One-year results of intravitreal ranibizumab with or without photodynamic therapy for polypoidal choroidal vasculopathy. Ophthalmologica. 2011, 226: 119-126. 10.1159/000329466.CrossRefPubMed
26.
Nakashizuka H, Mitsumata M, Okisaka S, Shimada H, Kawamura A, Mori R, Yuzawa M: Clinicopathologic findings in polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci. 2008, 49: 4729-4737. 10.1167/iovs.08-2134.CrossRefPubMed
27.
Wen F, Chen C, Wu D, Li H: Polypoidal choroidal vasculopathy in elderly Chinese patients. Graefes Arch Clin Exp Ophthalmol. 2004, 242: 625-629. 10.1007/s00417-003-0667-z.CrossRefPubMed
28.
Lai TY, Chan WM, Liu DT, Luk FO, Lam DS: Intravitreal bevacizumab (Avastin) with or without photodynamic therapy for the treatment of polypoidal choroidal vasculopathy. Br J Ophthalmol. 2008, 92: 661-666. 10.1136/bjo.2007.135103.CrossRefPubMed
29.
Kokame GT, Yeung L, Lai JC: Continuous anti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy: 6-month results. Br J Ophthalmol. 2010, 94: 297-301. 10.1136/bjo.2008.150029.CrossRefPubMed
30.
Wada H, Ura S, Kitaoka S, Satoh-Asahara N, Horie T, Ono K, Takaya T, Takanabe-Mori R, Akao M, Abe M, Morimoto T, Murayama T, Yokode M, Fujita M, Shimatsu A, Hasegawa K: Distinct characteristics of circulating vascular endothelial growth factor-a and C levels in human subjects. PLoS One. 2011, 6: e29351-10.1371/journal.pone.0029351.CrossRefPubMedPubMedCentral
31.
Cohen SY, Dubois L, Tadayoni R, Fajnkuchen F, Nghiem-Buffet S, Delahaye-Mazza C, Guiberteau B, Quentel G: Results of one-year’s treatment with ranibizumab for exudative age-related macular degeneration in a clinical setting. Am J Ophthalmol. 2009, 148: 409-413. 10.1016/j.ajo.2009.04.001.CrossRefPubMed
32.
Muether PS, Hoerster R, Hermann MM, Kirchhof B, Fauser S: Long-term effects of ranibizumab treatment delay in neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol. 2013, 251: 453-458. 10.1007/s00417-012-2038-0.CrossRefPubMed
33.
Reche-Frutos J, Calvo-Gonzalez C, Donate-Lopez J, Garcia-Feijoo J, Leila M, Garcia-Sanchez J: Short-term anatomic effect of ranibizumab for polypoidal choroidal vasculopathy. Eur J Ophthalmol. 2008, 18: 645-648.PubMed
34.
Hikichi T, Ohtsuka H, Higuchi M, Matsushita T, Ariga H, Kosaka S, Matsushita R, Takami K: Improvement of angiographic findings of polypoidal choroidal vasculopathy after intravitreal injection of ranibizumab monthly for 3 months. Am J Ophthalmol. 2010, 150: 674-682. 10.1016/j.ajo.2010.05.026.CrossRefPubMed
35.
Bessho H, Honda S, Imai H, Negi A: Natural course and funduscopic findings of polypoidal choroidal vasculopathy in a Japanese population over 1 year of follow-up. Retina. 2011, 31: 1598-1602. 10.1097/IAE.0b013e31820d3f28.CrossRefPubMed
36.
Koizumi H, Yamagishi T, Yamazaki T, Kinoshita S: Predictive factors of resolved retinal fluid after intravitreal ranibizumab for polypoidal choroidal vasculopathy. Br J Ophthalmol. 2011, 95: 1555-1559. 10.1136/bjophthalmol-2011-300285.CrossRefPubMed
37.
Boyer DS, Antoszyk AN, Awh CC, Bhisitkul RB, Shapiro H, Acharya NR, MARINA Study Group: Subgroup analysis of the MARINA study of ranibizumab in neovascular age-related macular degeneration. Ophthalmology. 2007, 114: 246-252. 10.1016/j.ophtha.2006.10.045.CrossRefPubMed
38.
Gomi F, Ohji M, Sayanagi K, Sawa M, Sakaguchi H, Oshima Y, Ikuno Y, Tano Y: One-year outcomes of photodynamic therapy in age-related macular degeneration and polypoidal choroidal vasculopathy in Japanese patients. Ophthalmology. 2008, 115: 141-146. 10.1016/j.ophtha.2007.02.031.CrossRefPubMed
39.
Honda S, Kurimoto Y, Kagotani Y, Yamamoto H, Takagi H, Uenishi M: Photodynamic therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy: a 30-month multicenter study in Hyogo, Japan. Jpn J Ophthalmol. 2009, 53: 593-597. 10.1007/s10384-009-0741-0.CrossRefPubMed
40.
Koh A, Lee WK, Chen LJ, Chen SJ, Hashad Y, Kim H, Lai TY, Pilz S, Ruamviboonsuk P, Tokaji E, Weisberger A, Lim TH: EVEREST STUDY: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina. 2012, 32: 1453-1464. 10.1097/IAE.0b013e31824f91e8.CrossRefPubMed
Metadata
Title
Effectiveness of intravitreal ranibizumab in exudative age-related macular degeneration (AMD): comparison between typical neovascular AMD and polypoidal choroidal vasculopathy over a 1 year follow-up
Authors
Wataru Matsumiya
Shigeru Honda
Sentaro Kusuhara
Yasutomo Tsukahara
Akira Negi
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2013
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/1471-2415-13-10

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