title: Long-term longitudinal study of patients treated with ranibizumab for neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To review the current literature regarding long-term treatment beyond 2 years with anti-vascular endothelial growth factor (VEGF) inhibition for neovascular age-related macular degeneration (nv-AMD).
  
  
  RESULTS
  Only few studies of anti-VEGF treatment for nv-AMD exist beyond 2 years, and the number of patients followed for 4 years or longer is small. The results of studies show that the majority of patients with nv-AMD can preserve visual acuity compared with baseline, subgroups reveal large variations in visual benefit. Approximately 20-30% of patients seem to respond poorly to the treatment, and 20% obtain a condition with inactivity and good results. The majority of patients will need continuous active treatment. Long-term decline of visual acuity reflects the natural progression of the disease, however, insufficient treatment cannot be excluded leaving a potential for further improvement. Close follow-up to detect recurrent activity of nv-AMD and activity in fellow eye is important. Definitive evidence of systemic side-effects is lacking, but long-term VEGF inhibition seems to be tolerated well with few ocular and systemic complications.
  
  
  CONCLUSIONS
  The majority of patients with nv-AMD can preserve visual acuity and expect long-term treatment beyond 2 years. Ocular complications and systemic adverse events remain few.
authors.affiliation: Research Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark.
authors.forename: Annette
authors.initials: A
authors.lastname: Rasmussen
authors.forename: Birgit
authors.initials: B
authors.lastname: Sander
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D000069579:Ranibizumab; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000187:drug effects / 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