As-Needed Treatment with Ranibizumab 0.5 mg in Patients with Neovascular Age-Related Macular Degeneration

Abstract

Purpose TO describe the results obtained in patients with neovascular age-related macular degeneration treated with ranibizumab 0.5 mg on an as-needed basis from the start after 1 year of follow-up. Methods Retrospective, consecutive interventional case series of patients with all angiographic types of neovascular age-related macular degeneration (mean baseline size, 3.4 disk areas) in a tertiary retinal center (Institut de la Màcula i la Retina; Barcelona, Spain). Main outcome was mean vision change; secondary outcomes were center retinal thickness change, number of injections, adverse events, and independent covariates associated with a good response. Results Mean visual acuity change was an increase of 1.3 letters (95% confidence interval −2.7 to +5.3), and difference between angiographic patterns did not reach statistical significance (p=0.30). A decrease in retinal thickness of 44.6 μm was identified (p<0.001), with a median of 3 injections. Absence of baseline arterial hypertension, lower visual acuity, and lesions located outside the fovea were associated with a better response to therapy. Conclusions As-needed treatment from the start achieved stabilization of visual acuity and a moderate decrease of retinal thickness with a low number of injections, but did not achieve the same efficacy as regular monthly injections.