title: Assessment of Corneal Sensation, Innervation and Retinal Nerve Fiber Layer in Patients Treated with Multiple Intravitreal Ranibizumab Injections.
abstract: OBJECTIVE
  To evaluate the effects of repeated intravitreal ranibizumab injections on corneal sensitivity, corneal sub-basal nerve plexus (SBNP) and peripapillary retinal nerve fiber layer (RNFL) thickness in patients with neovascular age-related macular degeneration (AMD).
  
  
  METHODS
  Sixty-six eyes of 33 patients who had received unilateral repeated intravitreal ranibizumab injections (0.5 mg/0.05 ml) for the treatment of AMD and 25 eyes of 25 healthy subjects were included in the study. Central corneal sensation was measured using the contact Cochet-Bonnet esthesiometer. The laser scanning in vivo corneal confocal microscope was used to determine corneal SBNP parameters. The peripapillary RNFL thickness was assessed with spectral-domain optical coherence tomography. Data obtained from the ranibizumab-injected eyes were compared with those of the fellow non-treated eyes and the eyes of the healthy control subjects.
  
  
  RESULTS
  The mean number of ranibizumab injections per eye was 8.9±5.0 (range 3-20). There were no statistically significant differences in the central corneal sensitivity threshold and corneal SBNP parameters between the ranibizumab-injected eyes and the fellow untreated eyes or between those with neovascular AMD and the healthy control group (P>0.05 for all). The average peripapillary RNFL thickness of the treated eyes did not differ significantly to the fellow eyes (P = 0.237), and the eyes of healthy control subjects (P = 0.918). There were no significant correlations between the number of ranibizumab injections and any of the study parameters.
  
  
  CONCLUSIONS
  Multiple intravitreal injections of ranibizumab seem to have no harmful effects on corneal sensitivity, innervation and peripapillary RNFL thickness in patients with AMD.
authors.affiliation: Department of Ophthalmology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
authors.forename: Gulfidan
authors.identifier: http://orcid.org/0000-0002-0509-5649
authors.initials: G
authors.lastname: Bitirgen
authors.affiliation: Department of Ophthalmology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
authors.forename: Selman
authors.initials: S
authors.lastname: Belviranli
authors.affiliation: Weill Cornell Medicine-Qatar, Education City, Doha, Qatar & Central Manchester University Teaching Hospitals Foundation Trust and Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
authors.forename: Rayaz A
authors.initials: RA
authors.lastname: Malik
authors.affiliation: Department of Ophthalmology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
authors.forename: Hurkan
authors.initials: H
authors.lastname: Kerimoglu
authors.affiliation: Department of Ophthalmology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
authors.forename: Gunhal
authors.initials: G
authors.lastname: Satirtav
authors.affiliation: Department of Ophthalmology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
authors.forename: Nazmi
authors.initials: N
authors.lastname: Zengin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000187:drug effects* / Q000294:innervation / Q000503:physiopathology; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009412:Nerve Fibers / Q000187:drug effects / Q000648:ultrastructure; D000069579:Ranibizumab / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012160:Retina / Q000187:drug effects* / Q000473:pathology / Q000648:ultrastructure
chemical_list: D000069579:Ranibizumab