title: Functional impact of treatment with ranibizumab under a reactive strategy in patients with neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To analyse the functional recovery using a pro re nata (PRN) dosing strategy with intravitreal injections of ranibizumab for patients with neovascular age-related macular degeneration (AMD).
  
  
  METHODS
  An observational, retrospective, single-centre study, was conducted on patients with neovascular AMD managed with a PRN strategy with ranibizumab, and were followed-up for a minimum of 18 months. Sociodemographic and clinical data were collected from medical records. The percentage of visual acuity (VA) recovered after losing 5 or more letters was calculated taking into account the previous visit, as well as considering the best VA recorded prior to the retreament.
  
  
  RESULTS
  The analysis included 128 patients. The mean (SD) follow-up period was 18.9 (2.3) months. The mean (SD) elapsed days between onset of symptoms and diagnosis, and between prescription and administration of treatment was 50.2 (57.4) and 10.9 (16.0), respectively. Only 108 patients were prescribed ranibizumab after losing 5 or more letters of VA. The mean (SD) VA recovery compared to the previous VA was 70.3% (114.4). On the other hand, the mean (SD) VA recovery when considering the best VA registered before the retreatment was 43.5% (112.9), with 59.4% of re-treatments having a VA recovery below 75%, and with 11.7% not presenting any VA recovery.
  
  
  CONCLUSIONS
  A PRN dosing strategy with intravitreal ranibizumab for neovascular AMD may not be efficient in preserving and/or recovering VA in the long-term, due to a cumulative irreversible VA loss.
authors.affiliation: Unidad de Mácula, Servicio de Oftalmología, Hospital Universitario y Politécnico La Fe, Valencia, España; RETICS RD160008 Enfermedades oculares, Prevención, detección precoz, tratamiento y rehabilitación de las enfermedades oculares; Instituto de Investigaciones Sanitarias La Fe, Hospital Universitario y Politécnico La Fe, Valencia, España. Electronic address: robertogallego@comv.es.
authors.forename: R
authors.initials: R
authors.lastname: Gallego-Pinazo
authors.affiliation: RETICS RD160008 Enfermedades oculares, Prevención, detección precoz, tratamiento y rehabilitación de las enfermedades oculares; Instituto de Investigaciones Sanitarias La Fe, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: R
authors.initials: R
authors.lastname: Dolz-Marco
authors.affiliation: RETICS RD160008 Enfermedades oculares, Prevención, detección precoz, tratamiento y rehabilitación de las enfermedades oculares; Instituto de Investigaciones Sanitarias La Fe, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: M
authors.initials: M
authors.lastname: Andreu-Fenoll
authors.affiliation: Bayer Hispania, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Farrés
authors.affiliation: Bayer Hispania, Barcelona, España.
authors.forename: L
authors.initials: L
authors.lastname: Monclús
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D010352:Patient Dropouts; D000069579:Ranibizumab / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000150:complications*
chemical_list: D020533:Angiogenesis Inhibitors; D000069579:Ranibizumab
keywords: Agudeza visual; Degeneración macular asociada; Neovascular AMD; PRN regimen; Pauta «tratar y extender»; Protocolo Pro Re Nata; Ranibizumab; Re-treatment; Retratamiento; Treat-and-extend regimen; Visual acuity