title: Intravitreal ranibizumab for choroidal neovascularization with large submacular hemorrhage in age-related macular degeneration.
abstract: OBJECTIVE
  To evaluate the effects of intravitreal ranibizumab injections in the treatment of choroidal neovascularization with large submacular hemorrhage secondary to age-related macular degeneration.
  
  
  METHODS
  Prospective interventional case series. Patients presenting occult choroidal neovascularization with flat large submacular hemorrhage >50% of the entire lesion were considered. The protocol required 3 monthly consecutive injections, followed by repeat injections over the 12-month follow-up on the basis of optical coherence tomography parameters and angiographic features.
  
  
  RESULTS
  Twenty-three patients were enrolled in the study and prospectively followed up. Mean best-corrected visual acuity and mean central macular thickness at the baseline were 0.82 ± 0.22 (logarithm of the minimum angle of resolution ± standard deviation) and 342 ± 56 µm, respectively. At 12-month examination, mean visual acuity improved significantly to 0.68 ± 0.41 (P = 0.04), and mean central macular thickness decreased to 236 ± 26 µm (P < 0.0001). A progressive resolution of macular bleeding was registered in 22 of 23 patients. No side effect or complication was registered.
  
  
  CONCLUSIONS
  Intravitreal ranibizumab can be considered a beneficial approach for the management of choroidal neovascularization with flat large submacular hemorrhage secondary to age-related macular degeneration.
authors.affiliation: *G. B. Bietti Foundation for Ophthalmology, Scientific Institute of Admission and Care, Rome, Italy; and †Department of Ophthalmology, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Iacono
authors.forename: Maurizio B
authors.initials: MB
authors.lastname: Parodi
authors.forename: Ugo
authors.initials: U
authors.lastname: Introini
authors.forename: Carlo
authors.initials: C
authors.lastname: La Spina
authors.forename: Monica
authors.initials: M
authors.lastname: Varano
authors.forename: Francesco
authors.initials: F
authors.lastname: Bandello
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004396:Coloring Agents; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008297:Male; D011446:Prospective Studies; D000069579:Ranibizumab; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D019233:Retreatment; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; D007208:Indocyanine Green; D000069579:Ranibizumab