Retinal Functional Changes Measured by Microperimetry in Neovascular Age-Related Macular Degeneration Treated With Ranibizumab

Parravano, Mariacristina; Oddone, Francesco; Tedeschi, Massimiliano; Chiaravalloti, Adele; Perillo, Loredana; Boccassini, Barbara; Varano, Monica

doi:10.1097/iae.0b013e3181cfd3c6

Cited by 47 publications

(42 citation statements)

References 31 publications

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“…11 In another trial, decrease in subretinal fluid volume and improvement in BCVA were strongly correlated, but no correlation was found between decreases in retinal and pigment epithelium detachment volumes and improvement in BCVA after three monthly ranibizumab injections. 19 Parravano et al 20 concluded that intravitreal injections of 0.5 mg ranibizumab were associated with progressive improvement of retinal sensitivity until 24 months, although BCVA values stabilized after 6 months, which suggested that microperimetry may give additional information about macular function that is missed by central VA testing alone.…”

Section: Discussionmentioning

confidence: 99%

Correlation of SD-OCT Features and Retinal Sensitivity in Neovascular Age-Related Macular Degeneration

Sulzbacher

Kiss

Kaider

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To correlate retinal sensitivity in patients with neovascular age-related macular degeneration (AMD) with specific characteristics of retinal morphology.METHODS. Thirty eyes of 30 patients presenting with active choroidal neovascularization were examined by spectral domain optical coherence tomography (SD-OCT) and microperimetry (MP-1). Image-processing software was used to match a fundus photographic (FP) MP-1 image with an infraredþOCT SD-OCT image. Each MP test point for retinal sensitivity was positioned at the corresponding SD-OCT location, and the microperimetric results were evaluated.RESULTS. An intact retinal configuration was associated with a median retinal sensitivity of 15.5 dB (quartiles: 12 dB, 18 dB). The median retinal sensitivities were 0 dB (quartiles: 0 dB, 1 dB) for the neovascular complex, 4 dB (0 dB, 9 dB) for the subretinal fluid, 1 dB (0 dB, 6 dB) for the intraretinal fluid, and 0 dB (0 dB, 3 dB) for intraretinal cysts. Pigment epithelium detachment was associated with a median retinal sensitivity of 3 dB (0 dB, 8 dB), and subretinal drusen had a median value of 8 dB (5 dB, 12 dB). Deep retinal layer analyses gave low median retinal sensitivities of 0 dB (0 dB, 3 dB) for an absent retinal pigment epithelium layer and 1 dB (0 dB, 5 dB) for an absent photoreceptor layer.CONCLUSIONS. Superimposition of morphological SD-OCT features and microperimetric retinal sensitivity allowed exact determination of the differential impact of retinal alteration on the corresponding sensitivity. Individual OCT-related indicators of neurosensory integrity were distinctly correlated with visual function. ''Morphofunctional'' findings could be relevant as prognostic factors and for (re)treatment decisions. (https:// www.clinicaltrialsregister.eu/ number, 2006-005684-26.) (Invest Ophthalmol Vis Sci. 2012;53:6448-6455)

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Section: Discussionmentioning

confidence: 99%

Correlation of SD-OCT Features and Retinal Sensitivity in Neovascular Age-Related Macular Degeneration

Sulzbacher

Kiss

Kaider

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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“…[18][19][20] Bolz et al 18 conducted a prospective study to evaluate the functional and morphological effects of three loading doses of intravitreal ranibizumab in 29 patients (29 eyes) with previously untreated nvAMD. Although they observed an improvement in VA, central retinal thickness, and central retinal sensitivity after 1 month, they did not observe any additional benefit following the subsequent second and third injections.…”

Section: Discussionmentioning

confidence: 99%

Microperimetric changes in neovascular age-related macular degeneration treated with ranibizumab

Alexander

Mushtaq

Osmond

et al. 2012

Eye

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Purpose To assess the value of microperimetry in eyes with neovascular age-related macular degeneration previously treated with ranibizumab and now in the maintenance phase of therapy. Methods A total of 21 eyes (14 patients) were included. Microperimetry was performed using the Macular Integrity Assessment Device on at least three occasions for each eye. Intravitreal ranibizumab was administered if visual acuity (VA) or optical coherence tomography (OCT) showed signs of active disease. Results Five eyes showed no change in VA or OCT findings, and required no intravitreal injections. In these eyes, mean threshold sensitivity (TS) decreased by 13% (paired t-test, P ¼ 0.05) during the study period, but fixation stability (FS) was unchanged. In all, 16 eyes showed signs of disease activity, and therefore required ranibizumab injections during the study. In these eyes, VA, central retinal thickness (CRT), FS, and TS remained unchanged during follow-up. Peak TS was noted when CRT was 210 lm; above or below 210 lm, there was a gradual reduction in TS. Conclusion This study has provided novel information on the relationship between macular sensitivity, CRT, and VA in the maintenance phase of ranibizumab therapy. Patients with stable VA and CRT may still have deteriorating retinal sensitivity. This is usually a late manifestation and may indicate subclinical CNV activity.

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“…Subgroup analysis revealed that decrease in CMT was noted overall but VA increased only in the patients with classic type CNV. Gardner, Vujosevic and Parravano explained this finding by the duration of the macular disease (Gardner et al, 2002;Vujosevic et al, 2006;Parravano et al, 2010). They suggested that a prolonged intra-and/or subretinal edema could lead to persisting and irreversible damage to the photoreceptors that could influence the functional changes after treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Compared the observed change in best corrected VA with change in central retinal sensitivity pretreatment and one month after three consecutive treatments with ranibizumab in patients with neovascular AMD and they found that compared with microperimetry, VA seems to significantly underestimate the change in visual function experienced by patients treated with ranibizumab. Parravano et al (2010) found that intravitreal injections of 0.5 mg ranibizumab determine progressive improvement of retinal sensitivity until 24 months, suggesting that microperimetry may give additional information about macular function not given by visual acuity alone. In addition, changes of functional status, as expressed by mean retinal sensitivity and visual acuity, were not found to be related either to baseline status or to the observed CRT changes.…”

Section: Discussionmentioning

confidence: 99%

The effect of intravitreal ranibizumab injection on visual acuity and central macular thickness in subgroups with neovascular age-related macular degeneration

Cömert¹,

Birinci²,

Süllü³

2013

jecm

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IntroductionAge-related macular degeneration (AMD) is the most common cause of legal blindness of 65 and over age group. Neovasculer AMD forms the 10 percent of the AMD but is responsible for 90 percent of the legal blindness (Ferris et al., 1984;Bird et al., 1995).In most of the cases, choroidal neovascularization (CNV) is located under the fovea (subfoveal) (Arias et al., 2009). At present, there are alternative treatment methods for subfoveal CNV such as photodynamic treatment (PDT) with verteporfin, intravitreal steroid or anti vascular endothelial growth factors (anti-VEGF; macugen, bevacizumab or ranibizumab) injection.Ranibizumab (Lucentis, Genentech Inc. South San Francisco, CA) is a recombinant, humanized monoclonal antibody fragment that inhibits all VEGF-A isoforms and was approved by the United States Food and Drug Administration for the treatment of neovascular AMD in June 2006 (Parravano et al., 2010).In our study, we assessed the effects of at least three intraocular ranibizumab injections, performed for the treatment of subfoveal choroidal neovascularization, on best corrected visual acuity and central macular thickness in patients who were classified by the component of lesion. Materials and methodsWe reviewed retrospectively, the cards of patients with neovascular AMD treated with intravitreal ranibizumab injections at Ondokuz Mayıs University, Department of Ophthalmology, from Feb 2009 to June 2011. We included 89 eyes of 89 patients, who underwent three consecutive injections of ranibizumab at monthly intervals.At baseline, best corrected visual acuity (VA) was measured by Snellen card and was recorded in logMAR-logarithm of the minimum angle of resolution values. Flouroscein anjiography (FA, Carl Zeiss Meditec AG, Jena, Germany) was performed and CNV have been classified in classic, occult or mixt (classic+occult) type. Central macular thickness (CMT)

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Retinal Functional Changes Measured by Microperimetry in Neovascular Age-Related Macular Degeneration Treated With Ranibizumab

Abstract: Intravitreal injections of 0.5 mg ranibizumab determine progressive improvement of retinal sensitivity until 24 months, although visual acuity levels off after 6 months, suggesting that microperimetry may give additional information about macular function not given by visual acuity alone.

Cited by 47 publications

References 31 publications

Correlation of SD-OCT Features and Retinal Sensitivity in Neovascular Age-Related Macular Degeneration

Correlation of SD-OCT Features and Retinal Sensitivity in Neovascular Age-Related Macular Degeneration

Microperimetric changes in neovascular age-related macular degeneration treated with ranibizumab

The effect of intravitreal ranibizumab injection on visual acuity and central macular thickness in subgroups with neovascular age-related macular degeneration

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