title: Tachyphylaxis during treatment of exudative age-related macular degeneration with ranibizumab.
abstract: OBJECTIVE
  To determine whether tachyphylaxis occurs during treatment with ranibizumab (Lucentis, Genentech, Inc., South San Francisco, California, USA) for exudative age-related macular degeneration (AMD).
  
  
  METHODS
  Retrospective review of cases.
  
  
  METHODS
  The treatment results of 1076 eyes (976 patients) treated with ranibizumab for exudative AMD was evaluated to identify patients with a potential tachyphylactic response. The participants had to have a minimum of 12 months follow-up.
  
  
  METHODS
  Tachyphylaxis was defined as a lack of response to the drug at the time of reactivation of choroidal neovascularisation (CNV) in patients who had responded to the initial treatment. The authors considered it a lack of response to ranibizumab if a decrease in vision and an increase in central retinal thickness (CRT) were observed despite repeated injections. Hence a stabilisation in vision and/or stabilisation in CRT during treatment were not considered tachyphylaxis, and other unfavourable responses such as a tear in the retinal pigment epithelium and therefore a decrease in vision during treatment were also not considered as tachyphylaxis. Every patient in this cohort who has had an injection-free interval after primary inactivation of CNV and who has received retreatment at a later stage was identified. In this population, those cases that did not respond to retreatment (tachyphylaxis) were identified and characterised.
  
  
  METHODS
  Number of patients who developed tachyphylaxis after treatment with ranibizumab.
  
  
  RESULTS
  20 patients (2%) developed tachyphylaxis during their treatment.
  
  
  CONCLUSIONS
  Tachyphylaxis can occur during the treatment of exudative AMD with ranibizumab. The precise mechanism for the development of tachyphylaxis is unclear. Both local and systemic factors might be involved.
authors: Department of Ophthalmology, Copenhagen University Hospital Roskilde, Køgevej 7-13, DK-4000 Roskilde, Denmark. sallingmus@hotmail.com
authors: Maria Salling
authors: MS
authors: Eghøj
authors: Torben Lykke
authors: TL
authors: Sørensen
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy*; D000069579:Ranibizumab; D012163:Retinal Detachment / Q000188:drug therapy; D012189:Retrospective Studies; D013618:Tachyphylaxis; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab