title: Intravitreal ranibizumab versus thermal laser photocoagulation in the treatment of extrafoveal classic choroidal neovascularization secondary to age-related macular degeneration.
abstract: BACKGROUND
  To compare the efficacy of thermal laser photocoagulation versus intravitreal ranibizumab for the treatment of extrafoveal classic choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).
  
  
  METHODS
  We conducted a retrospective study on 24 eyes with extrafoveal classic CNV secondary to AMD, treated either with thermal laser photocoagulation (group 1) or with intravitreal ranibizumab (group 2). Visual acuity, number of injections/sessions and recurrence rate were assessed.
  
  
  RESULTS
  The mean follow-up time was 23.6 ± 2.26 and 19.1 ± 9.74 months for group 1 and 2, respectively. Mean best corrected visual acuity (BCVA) of groups 1 and 2 was 0.59 ± 0.32 and 0.46 ± 0.30 logMAR, respectively (p = 0.343). At the end of the follow-up, mean BCVA of group 1 was 0.92 ± 0.35 and of group 2 0.16 ± 0.12 logMAR and differed statistically compared to baseline (p = 0.02 and p = 0.006, respectively). There was a statistically significant difference between the two groups as far as BCVA at the end of the follow-up was concerned (p < 0.0001). The patients in group 1 received on average 1.38 sessions of thermal laser photocoagulation, while patients in group 2 received on average 4 injections of ranibizumab. The recurrence rate in the laser group was 84.6%, while in the ranibizumab group it was 18.2% (p < 0.001). Specifically, the mean time of recurrence in the laser group was 11.5 months, whereas in the ranibizumab group it was 18 months (p = 0.048).
  
  
  CONCLUSIONS
  Intravitreal ranibizumab showed promising results in BCVA improvement and decrease in macular thickness in patients with extrafoveal classic CNV due to AMD, with a small number of injections. Laser photocoagulation treatment presented worsening in BCVA and high recurrence rate in our study with long-term follow-up.
authors.affiliation: First Department of Ophthalmology, University of Athens, Medical School of Athens, Athens, Greece.
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Ladas
authors.forename: Irini P
authors.initials: IP
authors.lastname: Chatziralli
authors.forename: Athanasios I
authors.initials: AI
authors.lastname: Kotsolis
authors.forename: Maria
authors.initials: M
authors.lastname: Douvali
authors.forename: Ilias
authors.initials: I
authors.lastname: Georgalas
authors.forename: Panagiotis G
authors.initials: PG
authors.lastname: Theodossiadis
authors.forename: Alexandros A
authors.initials: AA
authors.lastname: Rouvas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D020256:Choroidal Neovascularization / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis; D006801:Humans; D058449:Intravitreal Injections; D017075:Laser Coagulation; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D000069579:Ranibizumab; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab