title: Retinal functional changes measured by microperimetry in neovascular age-related macular degeneration treated with ranibizumab.
abstract: OBJECTIVE
  To evaluate the retinal functional changes measured by scanning laser ophthalmoscope microperimetry in neovascular age-related macular degeneration treated with ranibizumab injections.
  
  
  METHODS
  Prospective, interventional case series.
  
  
  METHODS
  A total of 42 eyes of 39 patients with neovascular age-related macular degeneration were included. After an initial 3 loading injections of ranibizumab, 0.5 mg per injection per month, injection was performed as needed. Evaluation of best-corrected visual acuity, microperimetry, and optical coherence tomography were performed before treatment and 3 months, 6 months, and 12 months after treatment. According to the appearance of the subfoveal choroidal neovascular membrane on fluorescein angiography, the study group was divided into patients with a predominantly or purely classic choroidal neovascular membrane, those with a minimally classic choroidal neovascular membrane, and patients with occult choroidal neovascular membrane.
  
  
  RESULTS
  In all the subjects, mean retinal sensitivity of the central 12-degree area had increased significantly from 4.89 ± 3.1 dB to 9.82 ± 2.1 dB at month 12 (P = .01). The number of absolute scotoma points decreased significantly from 11.3 ± 3.2 to 5.9 ± 2.4 at month 12 (P = .01). However, in the subgroup analysis, the mean retinal sensitivity improvement, decreased absolute scotoma size, best-corrected visual acuity improvement, and central macular thickness improvement did not differ significantly among the groups.
  
  
  CONCLUSIONS
  Intravitreal 0.5 mg ranibizumab therapy improves retinal function, quantified not only by visual acuity, but also by mean retinal sensitivity and fixation stability, as assessed by scanning laser ophthalmoscope microperimetry. Measurement of retinal sensitivity may facilitate evaluation of the effectiveness of intravitreal ranibizumab treatment in patients with neovascular age-related macular degeneration.
authors.affiliation: Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, Korea. ccnnrr@naver.com
authors.forename: Han Joo
authors.initials: HJ
authors.lastname: Cho
authors.forename: Chul Gu
authors.initials: CG
authors.lastname: Kim
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Yoo
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Cho
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Lee
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Kim
authors.forename: Joon H
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D019721:Ophthalmoscopes; D011446:Prospective Studies; D000069579:Ranibizumab; D012160:Retina / Q000503:physiopathology*; D012607:Scotoma / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab