title: As-needed treatment with ranibizumab 0.5 mg in patients with neovascular age-related macular degeneration.
abstract: OBJECTIVE
  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.
authors.affiliation: Macula and Retina Institute, Teknon Medical Center, Barcelona, Spain. biarnes@oo.upc.edu
authors.forename: Marc
authors.initials: M
authors.lastname: Biarnés
authors.forename: Jordi
authors.initials: J
authors.lastname: Monés
authors.forename: Joan R
authors.initials: JR
authors.lastname: Villalbí
authors.forename: Lluís
authors.initials: L
authors.lastname: Arias
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab