Ranibizumab therapy for choroidal neovascularization secondary to non-age-related macular degeneration causes

• Published in: Clinical & experimental ophthalmology 2012-01, Vol.40 (1), p.67-72
• Main Authors: Troutbeck, Robyn, Bunting, Roland, van Heerdon, Anton, Cain, Melinda, Guymer, Robyn
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Angiogenesis Inhibitors - adverse effects; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; choroidal neovascular membrane; Choroidal Neovascularization - drug therapy; Choroidal Neovascularization - etiology; Choroidal Neovascularization - physiopathology; Choroiditis - complications; Female; Fluorescein Angiography; Humans; Intravitreal Injections; Macular degeneration; Macular Degeneration - complications; Male; Medical research; Middle Aged; multifocal choroiditis; myopia; Myopia - complications; Prospective Studies; Ranibizumab; Tomography, Optical Coherence; Treatment Outcome; Visual Acuity - physiology
• ISSN: 1442-6404; 1442-9071
• DOI: 10.1111/j.1442-9071.2011.02719.x

Background:  To investigate the efficacy of ranibizumab therapy for choroidal neovascular (CNV) membranes secondary to conditions other than macular degeneration. Design:  Prospective case series conducted at the Royal Victorian Eye and Ear Hospital. Participants:  Twelve‐month follow‐up data for 41 patients with CNV recruited from the outpatient clinic from May 2008 to April 2010 is presented. Fifteen patients had myopia, seven had multifocal choroiditis, and eight had other primary causes. Methods:  All patients had visual acuity, fluorescein angiogram and optical coherence tomography performed at the initial visit (baseline). Ranibizumab was injected with a standard sterile technique. Patients were reviewed after 1 month, and further injections were given at the treating doctors' discretion. Main Outcome Measures:  Change in visual acuity and central macular thickness at 12 months was compared with baseline for each of the groups. Local and systemic adverse outcomes were recorded. Results:  Analysis was stratified by primary pathology. On average, 40%, 43% and 25% of patients with myopia, multifocal choroiditis and ‘other’ pathologies, respectively, experienced a three or more line improvement in vision. The average number of injections in 12 months was 4.2 for the entire group. Central macular thickness significantly decreased in the 12‐month period for the combined group (P = 0.03). No patient had an adverse systemic side‐effect; however, there was one case of endophthalmitis. Conclusions:  Ranibizumab is an effective treatment for CNV secondary to non‐age‐related macular degeneration causes, with most patients gaining an improvement in the first 2 months following injection.