Choroidal neovascularisation complicating geographic atrophy in age-related macular degeneration

Br J Ophthalmol. 2012 Dec;96(12):1479-83. doi: 10.1136/bjophthalmol-2012-302191. Epub 2012 Oct 17.

Abstract

Objective: To investigate the morphological and functional outcomes after intravitreal ranibizumab injections for choroidal neovascularisation (CNV) complicating geographic atrophy (GA).

Design: Retrospective, interventional, consecutive case series.

Methods: We reviewed the charts of all consecutive patients with GA due to age-related macular degeneration (AMD), who received intravitreal ranibizumab injections for the development of CNV at least 24 months earlier.

Results: 21 treatment-naive eyes of 21 consecutive patients (4 men, 17 women, mean age 86.9 ± 1.6 years) were included. In 95.2% of eyes a type 2 CNV was present, extrafoveal in 42.8% of cases. After a mean of 5.0 ± 0.87 (range 1-20) intravitreal ranibizumab injections, best-corrected visual acuity (BCVA) significantly worsened at the 24-month follow-up visit (0.73 ± 0.05 vs 0.88 ± 0.08 logMAR, respectively; p=0.01). A significant reduction of intraretinal cystic lesions, subretinal fluid and pigment epithelium detachment (p<0.001) and a significant increase of GA area (p=0.003) were present at last visit.

Conclusions: Ranibizumab treatment of GA-associated CNVs provides no BCVA improvement at 24 months follow-up despite an anatomic response of CNV. Low effectiveness of ranibizumab in these cases is likely due to GA progression.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / drug therapy
  • Choroidal Neovascularization / etiology*
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Geographic Atrophy / complications*
  • Geographic Atrophy / diagnosis
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Prognosis
  • Ranibizumab
  • Retrospective Studies
  • Visual Acuity

Substances

  • Antibodies, Monoclonal, Humanized
  • Ranibizumab