[Ranibizumab and exudative age-related macular degeneration: 5-year multicentric functional and anatomical results in real-life practice].
OBJECTIVE
The goal of this study was to evaluate five year functional and anatomical outcomes of wet AMD patients treated with ranibizumab according to a pro re nata (PRN) regimen in real-life practice.


METHODS
A retrospective, multicentric chart review of 201 eyes of 201 patients who underwent their first ranibizumab intravitreal injection (IVT) between January 1, 2007 and December 31, 2008 was performed. Best-corrected visual acuity (BCVA), central macular thickness (CMT) on SD-OCT, number of IVT and follow-up visits were collected at baseline and during the entire follow-up period of 5 years.


RESULTS
Mean BCVA at baseline was 52.3±16.5 letters. Mean BCVA change from baseline was respectively +2.8, +2.5, +1.8, -0.6 at 1, 2, 3, 4 years of follow-up. At year 5, 43% of eyes had a stable or improved letter score (≥0 letter gain), whereas 29% declined by 15 letters or more, with an overall significant mean decline of 2.8 letters (P<0.05). No correlation was observed between final visual outcome and age, baseline BCVA, type of neovascularization, naive status, number of IVT or number of follow-up visits. On SD-OCT, mean CMT was 293±96μm at baseline and was significantly reduced compared to baseline at each year end-point (P<0.005). The mean number of IVT was 15±10.4 at year 5, with 55% of eyes still being under active treatment.


CONCLUSIONS
PRN ranibizumab in real-life practice improved or stabilized visual acuity over 4 years. During the 5th year, progressive decline of visual acuity was observed.
Service d'ophtalmologie, université Paris Est Créteil, CHI de Créteil, 40, avenue de Verdun, 94000 Créteil, France.
E
E
Boulanger-Scemama
Centre Explore Vision, 75001 Paris, France.
D
D
Sayag
Service d'ophtalmologie, groupement des hôpitaux catholique de Lille, université catholique de Lille, 59000 Lille, France.
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T
Ha Chau Tran
Centre ophtalmologique Rabelais, 69003 Lyon, France.
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M
Quaranta-El Maftouhi
Centre Atlantique de la Vision, 17140 La Rochelle, France.
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F
Rumen
Service d'ophtalmologie, CHU de Dijon, 21079 Dijon, France.
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C
Creuzot-Garcher
Service d'ophtalmologie, université Paris Est Créteil, CHI de Créteil, 40, avenue de Verdun, 94000 Créteil, France.
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R
Blanco Garavito
Centre de recherche clinique, université Paris Est Créteil, CHI de Créteil, 94000 Créteil, France.
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C
Jung
Service d'ophtalmologie, université Paris Est Créteil, CHI de Créteil, 40, avenue de Verdun, 94000 Créteil, France. Electronic address: eric.souied@chicreteil.fr.
E
E
Souied
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D010818:Practice Patterns, Physicians'; D000069579:Ranibizumab / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects; D057135:Wet Macular Degeneration / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology* / Q000503:physiopathology
D020533:Angiogenesis Inhibitors; D000069579:Ranibizumab
Anti-VEGF; Anti-vascular endothelial growth factor; Dégénérescence maculaire liée à l’âge exsudative; Exudative age-related macular degeneration; Long-term follow-up; PRN regimen; Ranibizumab; Régime PRN; Suivi à long terme