Funduscopic results after 4-year follow-up treatment with ranibizumab for age-related macular degeneration in a region of Spain

BMC Ophthalmology

Research Article

Laura Monje-Fernandez¹  Sonia Villaron-Alvarez²  Marta Fernandez-Munoz³  Alejandro Anton⁴  Lourdes de Juan-Marcos⁵  Melissa Castrejon⁶  Rosa M Coco⁶  Itziar Fernandez⁷  M Rosa Sanabria⁸  M Isabel Lopez-Galvez⁹ 

[1] Complejo Asistencial Universitario de Leon, Leon, Spain;Complejo Asistencial de Avila, Avila, Spain;Complejo Asistencial de Palencia, Palencia, Spain;Complejo Hospitalario de Segovia, Segovia, Spain;Hospital Universitario de Salamanca, Salamanca, Spain;Instituto de Oftalmobiologia Aplicada, Universidad de Valladolid, Campus Miguel Delibes, P° de Belén n° 17, 47011, Valladolid, Spain;Instituto de Oftalmobiologia Aplicada, Universidad de Valladolid, Campus Miguel Delibes, P° de Belén n° 17, 47011, Valladolid, Spain;Ciber BBN, Zaragoza, Spain;Instituto de Oftalmobiologia Aplicada, Universidad de Valladolid, Campus Miguel Delibes, P° de Belén n° 17, 47011, Valladolid, Spain;Complejo Asistencial de Palencia, Palencia, Spain;Instituto de Oftalmobiologia Aplicada, Universidad de Valladolid, Campus Miguel Delibes, P° de Belén n° 17, 47011, Valladolid, Spain;Hospital Universitario de Valladolid, Valladolid, Spain;

关键词: Age-related macular degeneration (AMD);    Ranibizumab;    Optical coherence tomography (OCT);    Atrophy;    Disciform scar;    Outcome;   

DOI  :  10.1186/1471-2415-14-138

 received in 2014-06-22, accepted in 2014-11-04,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe study aims to survey longstanding funduscopic and functional outcomes of age-related macular degeneration (AMD) after ranibizumab treatment and verify the accuracy of a new method to compare the retinal thickness measured with different optical coherence tomography (OCT) tools.MethodsCase series included 314 eyes with 2–4 years of follow-up. Main Outcome Measures were visual acuity (VA), number of injections, retinal thickness, OCT morphology, and final macular funduscopic status.ResultsOne hundred twenty-two men and 177 women (mean age, 78.3 years) were included. The mean time to the first injection was 17.3 ± 14.6 days. Initial VA was O.8(20/125) ± 0.5; 0.7(20/100) ± 0.5 at 3 months; 0.8(20/125) ± 0.5 at a year; 1(20/200) ± 0.6 at year 2; 1(20/200) ± 0.6 at year 3 and 1.1(20/250) ± 0.6 at year 4. Number of visits at 3 months was 2.7 ± 0.8; 7.3 ± 2.1 at a year; 5.2 ± 2.7 along the 2nd year; 3.9 ± 2.3 at year 3 and 3.6 ± 2.2 at year 4. Number of injections at 3 months was 2.6 ± 0.5; 3.9 ± 1.5 at a year; 1.1 ± 1.5 along the 2nd year; 1.5 ± 2.4 at year 3 and 1.8 ± 3.1 at year 4. Patients with worse VA outcomes received more injections and were older. The formula to calculate changes in retinal thickness showed a 30% reduction in thickness, which correlated well with the OCT morphology. Patients with polypoidal choroidal vasculopathy (PCV) had a worse final outcome. The final disciform macular status (37%) was related to fewer injections and a greater decrease in thickness. Final well-preserved maculas (12.%) needed more injections and treatment changes; those that were atrophic at the final visit (30.8%) had a worse initial VA and greater decrease in thickness at the 3-month visit.ConclusionsYounger patients had better final outcomes. Our method to compare retinal thickness using different OCT tools worked well. The final visual outcome after a long follow-up was poor, which may be related to advanced age, poor initial VA, and the high incidence of final fibrosis or atrophy.

【 授权许可】

CC BY   
© Coco et al.; licensee BioMed Central Ltd. 2014