title: Four-year treatment results of neovascular age-related macular degeneration with ranibizumab and causes for discontinuation of treatment.
abstract: OBJECTIVE
  To evaluate 4-year treatment results of neovascular age-related macular degeneration with ranibizumab using a variable dosing regimen.
  
  
  METHODS
  Retrospective, single-center chart review.
  
  
  METHODS
  This was a retrospective single-center study that included 855 patients with neovascular age-related macular degeneration receiving treatment with ranibizumab during a 4-year period. Included in the study were patients with a minimum follow-up of 15 months and all patients who terminated treatment regardless of follow-up.
  
  
  RESULTS
  A total of 1321 patients were treated over the 4-year period, and 855 patients were eligible for inclusion. Of those, 456 patients were still receiving active treatment, whereas 399 patients had discontinued treatment. Overall treatment results showed a significant decrease in vision from 53.2 Early Treatment Diabetic Retinopathy Study letters (range, 1 to 85 letters) to 50.5 letters (range, 1 to 87 letters; P < .001). Mean follow-up was 23.3 months (range, 4 to 48 months). The reason for discontinuing treatment in 181 patients was no signs of activity, whereas 113 patients were judged to be nontreatable. Thirty-six patients declined further treatment for various reasons.
  
  
  CONCLUSIONS
  This report shows that when follow-up extends beyond 2 to 3 years, visual acuity does seem to decrease. Our data show that different responder groups can be identified: bad or nonresponders (approximately 15% of all patients) and good responders (approximately 21% of all patients). These 2 groups in general can be identified within the first 2 years of treatment, whereas the third group of regular responders (approximately 64% of all patients) require continuous monitoring and treatment for years.
authors.affiliation: Department of Ophthalmology, Copenhagen University Hospital Roskilde, Roskilde, Denmark. mfal@regionsjaelland.dk
authors.forename: Mads
authors.initials: M
authors.lastname: Krüger Falk
authors.forename: Henrik
authors.initials: H
authors.lastname: Kemp
authors.forename: Torben Lykke
authors.initials: TL
authors.lastname: Sørensen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D019233:Retreatment; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D028761:Withholding Treatment / Q000706:statistics & numerical data*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab