title: Functional outcomes after multiple treatments with ranibizumab in neovascular age-related macular degeneration beyond visual acuity.
abstract: OBJECTIVE
  To evaluate neuroretinal function and anatomical outcomes in patients with neovascular age-related macular degeneration (AMD) after three treatments with ranibizumab.
  
  
  METHODS
  Observational case reports.
  
  
  METHODS
  We investigated visual function in three patients, one female (80 years) and two male (77 and 74 years) with neovascular AMD. Twenty healthy participants served as control group. We measured visual acuity (Bailey-Lovie charts), contrast sensitivity (Pelli-Robson) and neuroretinal function using the multifocal electroretinogram (mfERG). Central macular thickness was evaluated using optical coherence tomography (OCT). Main outcome measures were central and peripheral mfERG peak to trough (N1P1) response density amplitudes and peak (P1) implicit times. All tests were performed before the first treatment (baseline) and after each of the three treatments with intravitreal 0.3 mg ranibizumab.
  
  
  RESULTS
  Visual acuity and contrast sensitivity remained stable or improved. Central macular thickness decreased after three treatments in all three patients. We found no significant change in central and peripheral neuroretinal function in the AMD patients between pre- and post-treatments 2 and 3. Although the mfERG amplitudes in the AMD patients were not significantly reduced compared with the age-similar group at baseline, there was a statistically significant reduction in central and peripheral mfERG amplitudes after three treatments
  
  
  CONCLUSIONS
  Anatomical outcomes and central visual function improved or remained stable in the three AMD patients in concordance with past reports. Further investigations of possible adverse effects of ranibizumab on the central and peripheral neuroretina in large prospective clinical trials are suggested.
authors: Institute of Health and Biomedical, Innovation and School of Optometry, Queensland University of Technology, Brisbane, Australia. b.feigl@qut.edu.au
authors: Beatrix
authors: B
authors: Feigl
authors: Amanda
authors: A
authors: Greaves
authors: Brian
authors: B
authors: Brown