title: Early visual impacts of optical coherence tomographic parameters in patients with age-related macular degeneration following the first versus repeated ranibizumab injection.
abstract: BACKGROUND
  The aim of this study is to evaluate the early visual impacts of various optical coherence tomographic (OCT) parameters after the first versus repeated intravitreal ranibizumab injection in patients with exudative age-related macular degeneration (AMD).
  
  
  METHODS
  A retrospective comparative case series study was conducted on 20 eyes of 18 consecutive patients who received intravitreal ranibizumab injection for exudative AMD either for the first time (group 1; n = 8) with no prior anti-vascular endothelial growth factor (anti-VEGF) injection in the same or fellow eye, or for repeated times during the course of monthly injected ranibizumab (group 2; n = 12 eyes). The following baseline and 1 month post-injection data was collected for both groups and compared: best-corrected visual acuity (BCVA), qualitative and quantitative OCT parameters including: foveal thickness, foveal volume (central 1-mm circle), retinal volume at 3- and 5-mm central circles, retinal pigment epithelium (RPE) elevation, type of fluid collections, and type of AMD lesion. The size of the fluid and fibrovascular lesion (FVL) areas were measured using manual delineation and automatic calculation of the device. We made correlations between the post-injection visual acuity (VA) and each of post-injection OCT parameters in both groups and these were the main outcome measures.
  
  
  RESULTS
  In group 1, there was a strong correlation between post-injection logarithm of minimum angle of resolution (logMAR) BCVA and each of the following: FVL size, foveal thickness, retinal volume at 3- and 5-mm central circles, RPE elevation, the size of the fluid area, and age of the patient (r > 0.70, p < 0.05), whereas in group 2; logMAR BCVA was strongly correlated only with foveal volume (r = 0.74, p = 0.01). Multivariate analysis showed that post-injection FVL size (r (2) = 0.69) and foveal volume (r (2) = 0.55) were the most important factors for VA 1 month following the initial and repeated ranibizumab injection, respectively.
  
  
  CONCLUSIONS
  The size of FVL and foveal volume showed a significant correlation with VA in AMD patients shortly after the first and repeated ranibizumab injection, respectively. Further studies with larger sample sizes are needed in order to support these results.
authors.affiliation: The Department of Ophthalmology and Visual Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.
authors.forename: Khulood Mohammed
authors.initials: KM
authors.lastname: Sayed
authors.forename: Takeshi
authors.initials: T
authors.lastname: Naito
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nagasawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Katome
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Mitamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012160:Retina / Q000187:drug effects / Q000473:pathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab