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. 2013 Jul 10:7:565-9.
doi: 10.2147/DDDT.S46610. Print 2013.

Effect of ranibizumab on serous and vascular pigment epithelial detachments associated with exudative age-related macular degeneration

Georgios D Panos  1 , Zisis Gatzioufas, Ioannis K Petropoulos, Doukas Dardabounis, Gabriele Thumann, Farhad Hafezi
Affiliations

Effect of ranibizumab on serous and vascular pigment epithelial detachments associated with exudative age-related macular degeneration

Georgios D Panos et al. Drug Des Devel Ther. .

Abstract

Purpose: To report the effect of intravitreal ranibizumab therapy for serous and vascular pigment epithelial detachments (PED) associated with choroidal neovascularisation (CNV) secondary to age-related macular degeneration (AMD).

Methods: In a prospective study, best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) data were collected for 62 eyes of 62 patients, with serous or vascular PED associated with CNV secondary to AMD. Intravitreal ranibizumab 0.5 mg was administered with a loading phase of three consecutive monthly injections, followed by monthly review with further treatment, as indicated according to the retreatment criteria of the PrONTO study. The change in visual acuity and PED height from baseline to month 12 after the first injection was determined.

Results: Sixty-one eyes of 61 patients (one of the patients developed retinal pigment epithelial tear and was excluded from the study) were assessed at the 12-month follow-up examination. There were two types of PED, including vascular PED in 32 patients (Group A) and serous PED (Group B) in 29 patients. The mean improvement of mean BCVA from baseline to 12 months was 0.09 logMAR (Logarithm of the Minimum Angle of Resolution) in Group A and 0.13 logMAR in Group B. Both groups showed significant improvement of the mean BCVA 12 months after the first injection compared with the baseline value (P < 0.05). In relation to the PED height, the mean decrease of mean PED height from baseline to 12 months was 135 μm in Group A and 180 μm in Group B. Both groups showed significant reduction of the PED height during the follow-up period (P < 0.01). The PED anatomical response to ranibizumab was not correlated with the BCVA improvement in any of the groups. Apart from one patient who developed pigment epithelial tear no other complications were documented.

Conclusion: Ranibizumab is an effective and safe treatment for improving vision in patients with serous and vascular PED, although the anatomical response of the PED to ranibizumab may not correlate directly with the visual outcome.

Keywords: age-related macular degeneration; choroidal neovascularisation; intravitreal injection; pigment epithelial detachment; ranibizumab.

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Figures

Figure 1
Figure 1
Selected case: A 76-year-old man was referred for decreased visual acuity in the left eye. Baseline examination, including (A) fundoscopy, (B) fluorescein angiography, (C) ICG angiography, and (D) macular OCT revealed a vascular PED associated with exudative AMD. The baseline BCVA and PED height were 20/80 and 380 μm, respectively. The same eye (E) at 3 months (BCVA: 20/70; PED height: 236 μm), (F) at 6 months (BCVA: 20/70; PED height: 176 μm), and (G) at 12 months (BCVA: 20/60; PED height: 166 μm), after the first ranibizumab injection. Abbreviations: AMD, age-related macular degeneration; BCVA, best-corrected visual acuity; ICG, indocyanine green; OCT, optical coherence tomography; PED, pigment epithelial detachment.
Figure 2
Figure 2
Selected case: A 72-year-old man was referred for decreased visual acuity in the left eye. Baseline examination, including (A) fundoscopy, (B) fluorescein angiography, (C) ICG angiography, and (D) macular OCT revealed a serous PED associated with exudative AMD. The baseline BCVA and PED height were 20/100 and 385 μm respectively. The same eye (E) at 3 months (BCVA: 20/80; PED height: 358 μm), (F) at 6 months (BCVA: 20/70; PED height: 297 μm), and (G) at 12 months (BCVA: 20/60; PED height: 251 μm) after the first ranibizumab injection. Abbreviations: AMD, age-related macular degeneration; BCVA, best-corrected visual acuity; ICG, indocyanine green; OCT, optical coherence tomography; PED, pigment epithelial detachment.
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