title: Effects of vitreomacular adhesion on ranibizumab treatment in Japanese patients with age-related macular degeneration.
abstract: OBJECTIVE
  To investigate the effects of vitreomacular adhesion (VMA) on intravitreal ranibizumab treatment in Japanese patients with exudative age-related macular degeneration (AMD).
  
  
  METHODS
  This was a retrospective comparative study that included 123 eyes from 123 patients with exudative AMD. The presence or absence of VMA was examined by spectral domain optical coherence tomography. The association of VMA with best-corrected visual acuity (BCVA) and central retinal thickness (CRT) at 3, 6, and 12 months after ranibizumab treatment was evaluated.
  
  
  RESULTS
  In the group of eyes without VMA [VMA(-)], the mean BCVA was 0.41 logMAR at baseline and significantly improved to 0.28, 0.30, and 0.29 logMAR at 3, 6, and 12 months following the initiation of treatment (P < 0.0001, <0.0001, <0.0001), respectively. In the group of eyes with VMA [VMA(+)], the mean BCVA was 0.42 logMAR at baseline, and there was no improvement at any of the measurement time-points during the follow-up period [0.39, 0.40, and 0.39 logMAR at 3, 6, and 12 months (P = 0.53, 0.75, 0.67), respectively]. The mean baseline CRT in the VMA(-) and VMA(+) groups was 326 and 370 µm, respectively, decreasing to 195 and 293 µm (P < 0.0001 and P = 0.0070), respectively, at 12 months. A better baseline BCVA was associated with poor visual response to intravitreal ranibizumab.
  
  
  CONCLUSIONS
  Our study of Japanese patients with AMD managed in real-world clinical practice revealed that both VMA and BCVA at baseline were associated with a poor visual response to intravitreal ranibizumab. These results are in agreement with previously reported findings for other ethnic groups.
authors.affiliation: Department of Ophthalmology, University of Tokyo School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan, nomurayoko-tky@umin.ac.jp.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Nomura
authors.forename: Hidenori
authors.initials: H
authors.lastname: Takahashi
authors.forename: Xue
authors.initials: X
authors.lastname: Tan
authors.forename: Shigeto
authors.initials: S
authors.lastname: Fujimura
authors.forename: Ryo
authors.initials: R
authors.lastname: Obata
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yanagi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012164:Retinal Diseases / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies; D000267:Tissue Adhesions; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000473:pathology*; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab
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