title: Changes in visual acuity in patients with wet age-related macular degeneration treated with intravitreal ranibizumab in daily clinical practice: the LUMIERE study.
abstract: OBJECTIVE
  To survey compliance with recommended intravitreal ranibizumab treatment protocols in daily clinical practice in France, with reference to outcomes.
  
  
  METHODS
  A retrospective, descriptive, observational study in patients with subfoveal wet age-related macular degeneration treated with ranibizumab. All historical data for the study period, including demographic, treatment, and disease details and visual acuity measurements (baseline, Month 3, and Month 12), were recorded retrospectively at least 12 months after the beginning of treatment.
  
  
  RESULTS
  In 551 patients followed by 16 ophthalmologists, 12 months of intravitreal ranibizumab treatment induced a mean visual acuity gain of 3.2 ± 14.8 Early Treatment Diabetic Retinopathy Study-equivalent letters. Fewer than 40% of patients received the recommended treatment of initial 3 monthly injections. More than 50% had to wait >8 days between diagnosis and treatment. At Month 3, visual acuity gain was greater in patients who had received recommended induction and in whom treatment was initiated quickly. At Month 12, the induction-related effect had largely disappeared but the time-to-treatment effect persisted. Patients had an average of 5.1 injections (2.6 during induction period). No patients were monitored monthly as stipulated in the guidelines.
  
  
  CONCLUSIONS
  Although poor compliance with recommendations has been reflected in mediocre outcomes, there is evidence that practice is improving.
authors.affiliation: Centre Ophtalmologique d'Imagerie et de Laser, Paris, France.
authors.forename: Salomon Y
authors.initials: SY
authors.lastname: Cohen
authors.forename: Gerard
authors.initials: G
authors.lastname: Mimoun
authors.forename: Hassiba
authors.initials: H
authors.lastname: Oubraham
authors.forename: Alain
authors.initials: A
authors.lastname: Zourdani
authors.forename: Christian
authors.initials: C
authors.lastname: Malbrel
authors.forename: Stephane
authors.initials: S
authors.lastname: Queré
authors.forename: Véronique
authors.initials: V
authors.lastname: Schneider
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; D005451:Fluorescein Angiography; D019983:Guideline Adherence; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; 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*; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab