title: Intravitreal ranibizumab for naive extrafoveal choroidal neovascularization secondary to age-related macular degeneration.
abstract: OBJECTIVE
  To investigate the effect of intravitreal ranibizumab on extrafoveal choroidal neovascularization secondary to age-related macular degeneration.
  
  
  METHODS
  Eighteen eyes affected by extrafoveal choroidal neovascularization secondary to age-related macular degeneration were prospectively enrolled in this study. After an initial intravitreal ranibizumab, all patients were reevaluated monthly over 12 months of follow-up. Further retreatments were performed on a pro re nata basis, depending on detection of any type of fluid on optical coherence tomography and/or the presence of leakage on fluorescein angiography. Primary outcome measures were mean changes in best-corrected visual acuity and the proportion of eyes gaining at least 15 letters (3 Early Treatment Diabetic Retinopathy Study [ETDRS] lines) at the end of the follow-up. Secondary outcome measures were central macular thickness variations and changes in choroidal neovascularization size.
  
  
  RESULTS
  Mean best-corrected visual acuity presented a significant improvement during the follow-up period, being 0.3 ± 0.2 logMAR at baseline and 0.2 ± 0.2 logMAR at the 12-month examination (P < 0.001). An improvement of at least 3 EDTRS lines was achieved by 6 eyes (33.3%), whereas 6 patients (33.3%) gained 1 to 2 lines. The mean central macular thickness at baseline was 314 ± 87 μm, changing to 268 ± 65 μm at the 12-month examination (P = 0.003). The mean lesion size was 1.4 ± 1.4 mm and remained stable throughout the follow-up, being 1.8 ± 2.9 mm at 12 months (P = 0.64).
  
  
  CONCLUSIONS
  Intravitreal ranibizumab administered after a pro re nata regimen with monthly evaluation is a beneficial approach for the management of extrafoveal choroidal neovascularization secondary to age-related macular degeneration over 12 months of follow-up. Further studies are warranted to confirm our preliminary results.
authors.affiliation: *Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy; †G. B. Bietti Foundation for Study and Research in Ophthalmology, IRCCS, Rome, Italy; and ‡San Paolo Ophthalmic Center, Sant' Antonio Hospital, Padua, Italy.
authors.forename: Maurizio B
authors.initials: MB
authors.lastname: Parodi
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Iacono
authors.forename: Carlo
authors.initials: C
authors.lastname: La Spina
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Iuliano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lo Giudice
authors.forename: Ugo
authors.initials: U
authors.lastname: Introini
authors.forename: Francesco
authors.initials: F
authors.lastname: Bandello
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D011446:Prospective Studies; D000069579:Ranibizumab; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000150:complications* / Q000188:drug therapy
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab