Intravitreal treatment in patients with exudative age-related macular degeneration and visual acuity ≤ 0.05.
BACKGROUND
To investigate intravitreal treatment efficiencies in patients suffering from exudative ARMD with a BCVA ≤ 0.05.


METHODS
Retrospective analysis: Analysis parameters were lesion type, BCVA at baseline and at follow-up, the intravitreal drug used, and its application frequency. Patients were divided into: 1) following injections of bevacizumab, triamcinolone, their combination, or ranibizumab regardless of their lesion subtype, 2) or by lesion subtype. Statistical tests were performed using Wilcoxon signed-rank tests, Kruskal-Wallis tests and multivariable logistic regressions.


RESULTS
Seventy four eyes of 74 patients were analyzed. Follow-up was at 12.0 to 15.7 weeks. Median difference of BCVA (logMAR) between baseline and follow-up was 0.000 (-0.030, 0.175) in classic (p = 0.105), 0.000 (-1.15, 0.20) in occult (p = 0.005), -0.200 (-1.20, 0.60) in cases with subretinal fluid (p = 0.207), 0.000 (-0.60, 0.30) in pigment epithelial detachment (p = 0.813), and 0.050 (-0.40, 0.70) in Junius Kuhnt maculopathy (p = 0.344). BCVA increased ≥ 0.2 logMAR in 4 (24 %) classic, 9 (47 %) occult, 6 (33 %) pigment epithelial detachment, 6 (55 %) subretinal fluid, in 29 (39 %) eyes regardless of the lesion type, and reached a BCVA ≥ 0.05 in 7 (9 %) of those with a baseline BCVA <0.05.


CONCLUSIONS
Results indicate that in patients with ARMD and a BCVA lower 0.05, intravitreal treatment may improve visual acuity, most probably in cases with occult lesions.
Institute of Biostatistics and Clinical Research, University of Muenster, Schmeddingstraße 56, 48149, Münster, Germany. Raphael.Koch@ukmuenster.de.
Raphael
R
Koch
Department of Ophthalmology, University of Muenster Medical Center, Albert Schweitzer Campus 1, Building D15, 48149, Münster, Germany. schmidt.matthias@aol.de.
Matthias
M
Schmidt
Department of Ophthalmology, University of Muenster Medical Center, Albert Schweitzer Campus 1, Building D15, 48149, Münster, Germany. binegeb@web.de.
Sabine
S
Gebauer
Department of Ophthalmology, University of Muenster Medical Center, Albert Schweitzer Campus 1, Building D15, 48149, Münster, Germany. holger.busse@yahoo.de.
Holger
H
Busse
Department of Ophthalmology, University of Muenster Medical Center, Albert Schweitzer Campus 1, Building D15, 48149, Münster, Germany. uhligc@uni-muenster.de.
Constantin E
CE
Uhlig
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005122:Exudates and Transudates; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000627:therapeutic use; D012189:Retrospective Studies; D058471:Subretinal Fluid; D014222:Triamcinolone Acetonide / Q000627:therapeutic use; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology*; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology*
D020533:Angiogenesis Inhibitors; D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide; D000069579:Ranibizumab