title: CHANGES IN VISUAL ACUITY IN PATIENTS WITH WET AGE-RELATED MACULAR DEGENERATION TREATED WITH INTRAVITREAL RANIBIZUMAB IN DAILY CLINICAL PRACTICE: The TWIN Study.
abstract: OBJECTIVE
  The real-life LUMIERE study on patients with wet age-related macular degeneration treated with intravitreal ranibizumab in 2006 to 2009 showed that failure to follow recommendations was associated with lower efficacy than had been observed in the development phase. The TWIN Study reviewed the situation in 2010 to 2011.
  
  
  METHODS
  Retrospective, descriptive purely observational study of data acquired after 12 months of treatment with intravitreal ranibizumab.
  
  
  RESULTS
  In 881 patients (68% women, mean age, 79 years) treated by 21 ophthalmologists, the mean gain in visual acuity was +4.3 ± 15.4 letters (up from 3.2 ± 14.8 in 2006-2009; NS). Significant improvements were documented in the mean interval between diagnosis and treatment initiation (down from 12.6 ± 26.4-7.7 ± 10.9 days; P < 0.001), and in the percentage of patients who received a full course of induction treatment (56.6 vs. 39.6%; P < 0.001). After induction, hardly any patients were monitored every month as recommended, although retreatment was more assiduous (5.6 ± 2.3 vs. 5.1 ± 2.1 injections; P < 0.001).
  
  
  CONCLUSIONS
  Despite improvements in key parameters, the effectiveness of intravitreal ranibizumab is still compromised by poor compliance with the guidelines, especially the frequency of postinduction monitoring that is now the most important determinant of successful treatment.
authors.affiliation: *Department of Ophthalmology, Hôpital Intercommunal de Créteil, University Paris Est Créteil, Créteil, France; †Department of Ophthalmology, Centre Hospitalier, Orleans, France; ‡Centre d'Imagerie de l'Ecole Militaire, Paris, France; §Centre Ophtalmologique d'Imagerie et de Laser, Paris France; and ¶Novartis Pharma SAS, Paris, France.
authors.forename: Eric H
authors.initials: EH
authors.lastname: Souied
authors.forename: Hassiba
authors.initials: H
authors.lastname: Oubraham
authors.forename: Gérard
authors.initials: G
authors.lastname: Mimoun
authors.forename: Salomon Y
authors.initials: SY
authors.lastname: Cohen
authors.forename: Stéphane
authors.initials: S
authors.lastname: Quere
authors.forename: Audrey
authors.initials: A
authors.lastname: Derveloy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D005451:Fluorescein Angiography; D019983:Guideline Adherence; D058449:Intravitreal Injections; D017410:Practice Guidelines as Topic; D000069579:Ranibizumab / Q000627:therapeutic use; D019233:Retreatment; D012189:Retrospective Studies; 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; D000069579:Ranibizumab; D042461:Vascular Endothelial Growth Factor A; C467484:VEGFA protein, human