Treatment outcomes of conventional or high-dose ranibizumab for vascularized pigment epithelial detachment based on lesion subtypes

A post hoc study was conducted to compare visual and anatomic outcomes of vascularized serous pigment epithelial detachment (Group 1) with fibrovascular pigment epithelial detachment (Group 2) due to age-related macular degeneration treated with either 0.5 or 2.0 mg ranibizumab injections. A prospec...

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Bibliographic Details
Published in:European journal of ophthalmology Vol. 28; no. 6; p. 677
Main Authors: Chan, Clement K, Sarraf, David, Abraham, Prema
Format: Journal Article
Language:English
Published: United States 01.11.2018
Subjects:
Aged
Aged, 80 and over
Analysis of Variance
Angiogenesis Inhibitors - therapeutic use
Choroidal Neovascularization - drug therapy
Choroidal Neovascularization - pathology
Contrast Sensitivity - physiology
Female
Humans
Intravitreal Injections
Male
Middle Aged
Prospective Studies
Ranibizumab - therapeutic use
Retinal Detachment - drug therapy
Retinal Detachment - pathology
Retinal Detachment - physiopathology
Retinal Pigment Epithelium - pathology
Tomography, Optical Coherence
Vascular Endothelial Growth Factor A - antagonists & inhibitors
Visual Acuity - physiology
retinal pigment epithelial tears
vascularized pigment epithelial detachment
Fibrovascular pigment epithelial detachment
vascularized serous pigment epithelial detachment
ISSN:1724-6016, 1724-6016
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Summary:A post hoc study was conducted to compare visual and anatomic outcomes of vascularized serous pigment epithelial detachment (Group 1) with fibrovascular pigment epithelial detachment (Group 2) due to age-related macular degeneration treated with either 0.5 or 2.0 mg ranibizumab injections. A prospective, randomized trial was performed with the following regimens for 12 months: (1) 0.5 mg monthly, (2) 0.5 mg monthly for 4 months followed by pro re nata injections, (3) 2.0 mg monthly, and (4) 2.0 mg monthly for 4 months followed by pro re nata injections. Primary measure was best-corrected standardized vision. Secondary measures included central subfield, thickness surface area A , greatest linear diameter, heights of pigment epithelial detachment and choroidal neovascularization (CNV), subretinal fluid, cystoid macular edema, and adverse events. For 36 eyes (8 in Group 1 and 28 in Group 2), follow-up time was 12 months. There were no differences in baseline features between groups except for pigment epithelial detachment A (Group 2 > Group 1). Two-way analysis of variance showed comparable improvements in anatomic and vision outcomes. Three-way analysis of variance also showed similar responses for both lesion subtypes with high-dose treatment. There was a trend toward greater pigment epithelial detachment resolution in Group 1 eyes. There were no differences in retinochoroidal angiomatous proliferation (Type-3 CNV) and cataracts between groups, although greater percentages of eyes in Group 1 developed retinal pigment epithelial tears (25% vs 10.7%). There were no differences in vision and anatomic outcomes between lesion subtypes, and similarly, more rapid responses to high-dose than conventional-dose ranibizumab occurred for eyes with both lesion subtypes. More retinal pigment epithelial tears may develop in eyes with vascularized serous pigment epithelial detachment.
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ISSN:1724-6016
1724-6016
DOI:10.1177/1120672117747034