title: High-dose ranibizumab therapy for vascularized pigment epithelial detachment.
abstract: OBJECTIVE
  The conventional dose of anti-vascular endothelial growth factor treatment may slowly reduce the subretinal fluid and height of a vascularized pigment epithelial detachment (vPED), but rarely leads to its complete resolution. We report a dramatic outcome involving a high dose (2 mg) of ranibizumab for treating vPED.
  
  
  METHODS
  This report describes three eyes with vPED that received 2 mg in 0.05 ml of ranibizumab injections on a monthly basis and were followed prospectively. Each patient received a complete ocular examination, including best-corrected standardized ETDRS testing, fundus photography (FP), fluorescein angiography (FA), optical coherent tomography (OCT), and indocyanine-green angiography at baseline. ETDRS and OCT testing were repeated monthly, while FP and FA were performed every 3 months.
  
  
  RESULTS
  Following a single intravitreal injection of 2 mg ranibizumab, there was rapid resolution of the subretinal fluid, haemorrhage, exudates, and flattening of the vPED within 10 days for Case 1, and within 1 month for Case 2 and Case 3.
  
  
  CONCLUSIONS
  Rapid and dramatic decrease in the exudative changes and collapse of the vPED may develop after a single injection of high-dose (2 mg) ranibizumab in certain eyes with a vPED. The improvement was maintained with additional monthly injections to 12 months.
authors.affiliation: Southern California Desert Retina Consultants, Medical Group, Palm Desert, CA 92263, USA. Pschan@aol.com
authors.forename: C K
authors.initials: CK
authors.lastname: Chan
authors.forename: P
authors.initials: P
authors.lastname: Abraham
authors.forename: D
authors.initials: D
authors.lastname: Sarraf
mesh_terms: D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D004396:Coloring Agents; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012163:Retinal Detachment / Q000175:diagnosis / Q000188:drug therapy*; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000188:drug therapy*; D055213:Retinal Pigment Epithelium / Q000187:drug effects* / Q000473:pathology; D058471:Subretinal Fluid / Q000187:drug effects; 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; D004396:Coloring Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D007208:Indocyanine Green; D000069579:Ranibizumab