title: Treatment of exudative age-related macular degeneration with intravitreal ranibizumab in clinical practice: a 3-year follow-up.
abstract: OBJECTIVE
  To evaluate the 36-month efficacy of intravitreal ranibizumab injections for choroidal neovascularization secondary to age-related macular degeneration (AMD) in real world clinical practice.
  
  
  METHODS
  Retrospective study involving 84 eyes of 77 patients; 52 eyes completed 3 years of follow-up. Subjects were observed initially on a monthly basis and with extended follow-up intervals if signs of quiescence were detected, according to an established protocol. A comprehensive ophthalmologic examination was performed, including best-corrected visual acuity (BCVA) determined with Early Treatment Diabetic Retinopathy Study charts, stereoscopic macular biomicroscopy and optical coherence tomography (OCT) with fluorescein angiography and indocyanine green angiography if considered necessary. Treatment was given if signs of active lesions were present.
  
  
  RESULTS
  The mean baseline BCVA was 49.33 and 49.52 letters at the 36-month visit. The average of treatments was 8.6 at 3 years. At this time point, 77% of treated eyes stabilized or improved their vision (VA loss ≤ 5 letters). A predictive value for better VA was found for younger age, better baseline VA, good response on OCT and more frequent treatments.
  
  
  CONCLUSIONS
  At 3 years, intravitreal ranibizumab is able to maintain baseline VA in exudative AMD patients, with a reduced number of injections, but not to show VA improvement, in clinical practice.
authors.affiliation: Department of Ophthalmology, University Hospital of Coimbra, Coimbra, Portugal. inespdmarques@yahoo.com
authors.forename: Inês P
authors.initials: IP
authors.lastname: Marques
authors.forename: Pedro
authors.initials: P
authors.lastname: Fonseca
authors.forename: M
authors.initials: M
authors.lastname: Luz Cachulo
authors.forename: Isabel
authors.initials: I
authors.lastname: Pires
authors.forename: João
authors.initials: J
authors.lastname: Figueira
authors.forename: J R
authors.initials: JR
authors.lastname: Faria de Abreu
authors.forename: Rufino
authors.initials: R
authors.lastname: Silva
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects*; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab