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Five-year treatment outcomes following intravitreal ranibizumab injections for neovascular age-related macular degeneration in Japanese patients.
Graefes Arch Clin Exp Ophthalmol 2019; 257(7):1411-1418GA

Abstract

PURPOSE

To assess the real-world 5-year treatment outcomes of ranibizumab therapy in Japanese patients with neovascular age-related macular degeneration (AMD).

METHODS

This was a retrospective, observational, and open-label effectiveness study that included 295 eyes. The participants were patients with treatment-naïve neovascular AMD who received intravitreal ranibizumab (IVR) monthly injection at least three times as the loading phase, followed by further injections as needed (pro re nata (PRN)) and follow-up assessments for 5 years. Outcomes were determined at least 5 years after the first ranibizumab injection.

RESULTS

Mean logMAR best-corrected visual acuity (BCVA) at baseline was 0.52. The mean BCVA significantly improved after three loading injections; however, it declined gradually. The BCVA at 1 year was significantly better than the baseline BCVA, whereas the 3-year, 4-year, and 5-year BCVA values were significantly lower than the baseline values. The average central foveal thickness improved significantly from 366 ± 125 μm to 268 ± 134 μm (p < 0.0001). Macular atrophy was significantly more likely to occur in cases with classic choroidal neovascularization (CNV) than in cases with other AMD (p = 0.01).

CONCLUSIONS

IVR is well tolerated in eyes with AMD. However, a PRN regimen for AMD may have limited real-world effectiveness for long-term maintenance of improved visual acuity. Macular atrophy may occur more frequently in classic CNV. To maintain good vision, IVR treatment should be started earlier and performed continuously.

Authors+Show Affiliations

Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. yuji@eye.med.kyushu-u.ac.jp. Department of Ophthalmology, Fukuoka University Chikushi Hospital, Fukuoka, Japan. yuji@eye.med.kyushu-u.ac.jp.Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

31119425

Citation

Wada, Iori, et al. "Five-year Treatment Outcomes Following Intravitreal Ranibizumab Injections for Neovascular Age-related Macular Degeneration in Japanese Patients." Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, vol. 257, no. 7, 2019, pp. 1411-1418.
Wada I, Oshima Y, Shiose S, et al. Five-year treatment outcomes following intravitreal ranibizumab injections for neovascular age-related macular degeneration in Japanese patients. Graefes Arch Clin Exp Ophthalmol. 2019;257(7):1411-1418.
Wada, I., Oshima, Y., Shiose, S., Kano, K., Nakao, S., Kaizu, Y., ... Sonoda, K. H. (2019). Five-year treatment outcomes following intravitreal ranibizumab injections for neovascular age-related macular degeneration in Japanese patients. Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, 257(7), pp. 1411-1418. doi:10.1007/s00417-019-04361-8.
Wada I, et al. Five-year Treatment Outcomes Following Intravitreal Ranibizumab Injections for Neovascular Age-related Macular Degeneration in Japanese Patients. Graefes Arch Clin Exp Ophthalmol. 2019;257(7):1411-1418. PubMed PMID: 31119425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Five-year treatment outcomes following intravitreal ranibizumab injections for neovascular age-related macular degeneration in Japanese patients. AU - Wada,Iori, AU - Oshima,Yuji, AU - Shiose,Satomi, AU - Kano,Kumiko, AU - Nakao,Shintaro, AU - Kaizu,Yoshihiro, AU - Yoshida,Shigeo, AU - Ishibashi,Tatsuro, AU - Sonoda,Koh-Hei, Y1 - 2019/05/22/ PY - 2019/03/14/received PY - 2019/05/14/accepted PY - 2019/05/06/revised PY - 2019/5/24/pubmed PY - 2019/6/27/medline PY - 2019/5/24/entrez KW - Age-related macular degeneration KW - Long-term treatment KW - Macular atrophy KW - Pro re nata treatment KW - Ranibizumab SP - 1411 EP - 1418 JF - Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie JO - Graefes Arch. Clin. Exp. Ophthalmol. VL - 257 IS - 7 N2 - PURPOSE: To assess the real-world 5-year treatment outcomes of ranibizumab therapy in Japanese patients with neovascular age-related macular degeneration (AMD). METHODS: This was a retrospective, observational, and open-label effectiveness study that included 295 eyes. The participants were patients with treatment-naïve neovascular AMD who received intravitreal ranibizumab (IVR) monthly injection at least three times as the loading phase, followed by further injections as needed (pro re nata (PRN)) and follow-up assessments for 5 years. Outcomes were determined at least 5 years after the first ranibizumab injection. RESULTS: Mean logMAR best-corrected visual acuity (BCVA) at baseline was 0.52. The mean BCVA significantly improved after three loading injections; however, it declined gradually. The BCVA at 1 year was significantly better than the baseline BCVA, whereas the 3-year, 4-year, and 5-year BCVA values were significantly lower than the baseline values. The average central foveal thickness improved significantly from 366 ± 125 μm to 268 ± 134 μm (p < 0.0001). Macular atrophy was significantly more likely to occur in cases with classic choroidal neovascularization (CNV) than in cases with other AMD (p = 0.01). CONCLUSIONS: IVR is well tolerated in eyes with AMD. However, a PRN regimen for AMD may have limited real-world effectiveness for long-term maintenance of improved visual acuity. Macular atrophy may occur more frequently in classic CNV. To maintain good vision, IVR treatment should be started earlier and performed continuously. SN - 1435-702X UR - https://www.unboundmedicine.com/medline/citation/31119425/Five_year_treatment_outcomes_following_intravitreal_ranibizumab_injections_for_neovascular_age_related_macular_degeneration_in_Japanese_patients_ L2 - https://dx.doi.org/10.1007/s00417-019-04361-8 DB - PRIME DP - Unbound Medicine ER -