title: Earlier therapeutic effects associated with high dose (2.0 mg) Ranibizumab for treatment of vascularized pigment epithelial detachments in age-related macular degeneration.
abstract: CONCLUSIONS
  Intravitreal high dose (2 mg) ranibizumab may lead to quicker resolution of choroidal neovascularization (CNV) and associated retinal pigment epithelial detachment in eyes with exudative age-related macular degeneration, although it may possibly correlate with RPE tears in certain cases.
  
  
  OBJECTIVE
  This prospective study compared the outcomes of 0.5 vs 2.0 mg intravitreal ranibizumab injections (RI) for treating vascularized pigment epithelial detachment (vPED) due to age-related macular degeneration.
  
  
  METHODS
  Patients with vPED were randomized to receive 2.0 vs 0.5 mg RI monthly for 12 months or for 4 months and then repeated on a pro-re nata basis. Optical coherence tomography, fundus photography, and fluorescein and indocyanine-green angiography were obtained at baseline and subsequent specific intervals. Outcome measures were best-corrected standardized visual acuities, central 1-mm thickness, surface area (SA), greatest linear diameter (GLD), heights (PED and CNV), and amount of subretinal fluid (SRF) and cystoid macular edema (CME).
  
  
  RESULTS
  Both groups yielded reductions of the central 1-mm thickness, PED and CNV SA and PED height and GLD, SRF, and CME. Vision improvement and reduction in SRF and PED height occurred earlier for eyes receiving the 2.0 mg dose. Cataract progression was similar but RPE tears developed more often with the 2.0 mg dose.
  
  
  CONCLUSIONS
  There were similar visual and anatomical outcomes at the end of the study; however, the higher dose yielded more rapid reductions and more complete resolution of the PED, although there was possible increased tendency for an RPE tear with the higher dose.
authors.affiliation: 1] Southern California Desert Retina Consultants, Palm Desert, CA, USA [2] Loma Linda University, Department of Ophthalmology, Loma Linda, CA, USA.
authors.forename: C K
authors.initials: CK
authors.lastname: Chan
authors.affiliation: Black Hills Regional Eye Institute, Rapid City, SD, USA.
authors.forename: P
authors.initials: P
authors.lastname: Abraham
authors.affiliation: Retinal Disorders and Ophthalmic Genetics, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USA.
authors.forename: D
authors.initials: D
authors.lastname: Sarraf
authors.affiliation: Southern California Desert Retina Consultants, Palm Desert, CA, USA.
authors.forename: A S D
authors.initials: AS
authors.lastname: Nuthi
authors.affiliation: Southern California Desert Retina Consultants, Palm Desert, CA, USA.
authors.forename: S G
authors.initials: SG
authors.lastname: Lin
authors.affiliation: Retinal Disorders and Ophthalmic Genetics, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: McCannel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000009:adverse effects; D004396:Coloring Agents; D015350:Contrast Sensitivity; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008297:Male; D011446:Prospective Studies; D000069579:Ranibizumab; D012163:Retinal Detachment / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D055213:Retinal Pigment Epithelium / Q000098:blood supply*; D018570:Risk Assessment; D018434:Sickness Impact Profile; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D007208:Indocyanine Green; D000069579:Ranibizumab