The Effect of Required Injection Numbers during the First Year on the Clinical Course of Neovascular Age-related Macular Degeneration
Abdullah Ozkaya
Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
Ihsan Yilmaz *
Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
Zeynep Alkin
Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
Yalcin Karakucuk
Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
Ahmet Taylan Yazici
Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
*Author to whom correspondence should be addressed.
Abstract
Aims: To evaluate the effect of injection number of ranibizumab on an as-needed treatment regimen during the first year of treatment on the clinical course of neovascular age-related macular degeneration (nAMD).
Study Design: Retrospective study.
Place and Duration of Study: Beyoglu Eye Training and Research Hospital. Department of Retina, between December 2009 and December 2011.
Methodology: The newly diagnosed nAMD patients who were treated with intravitreal ranibizumab on an as-needed treatment regimen with a follow-up period of at least 24 months were included in the study. The patients were divided into three groups according to the required injection numbers during the first year; group 1, 3 injections; group 2, 4-5 injections; group 3≥5 injections. Main outcome measures were the change in best corrected visual acuity (BCVA), and central retinal thickness (CRT). Secondary outcome measure was the number of injections during the second year.
Results: The study included 92 eyes of 87 patients. Group 1 consisted of 14 eyes (15.2%), group 2 consisted of 30 eyes (32.6%), and group 3 consisted of 48 eyes (52.2%). The visual outcomes seemed better in group 1; however, there was not a statistically significant difference among the three groups in regards of change in BCVA at all of the time points (p=0.4 for month 6, p=0.5 for month 12, p=0.6 for month 18, p=0.6 for month 24). There was not a statistically significant difference among the three groups in regards of change in CRT at all of the time points (p=0.2 for month 6, p=0.2 for month 12, p=0.1 for month 18, p=0.6 for month 24). The mean number of injections at month 12 and 24 was statistically different among the three groups (p<0.0001 for both).
Conclusion: This study did not show a relationship between injection numbers and treatment outcomes in patients with nAMD on an as-needed treatment regimen. However there was a difference among the three groups in regard of visual acuity which was not statistically significant.
Keywords: Age-related macular degeneration, as-needed treatment, ranibizumab, AMD