The effects of ranibizumab injections on fluorescein angiographic findings and visual acuity recovery in age-related macular degeneration

Abstract

AimThe objective of the study reported here was to evaluate the effect of ranibizumab on retinal circulation times and vessel caliber and to analyze the correlation of these factors with visual acuity (VA) prognosis in patients with age-related macular degeneration (AMD).Subjects and methodsThis prospective cohort study included 52 eyes of 46 patients (mean age 73.5 years [standard deviation 7.7]; 28 males, 18 females). The study parameters were best-corrected visual acuity (BCVA), central macular thickness (CMT) (pre- and posttreatment: for 3 months after the last injection), retinal circulation times, diameter of retinal arteriole (DRA), and diameter of retinal vein (DRV) (pre- and posttreatment: after a loading dose of three consecutive injections of ranibizumab with a 4-week interval in the initial phase). The pretreatment, posttreatment measurements, and their differences were recorded for analyses. The injections were repeated when needed. Eyes were grouped into one of two groups according to VA recovery: Group 1, cases showing significant recovery of VA (n=21, 37%), and Group 2, cases showing preservation of VA (n=22, 42%) and deterioration of VA (n=11, 21%). Differences were compared statistically in and between groups. Logistic regression analysis was undertaken to determine the correlation of these parameters with VA recovery.ResultsThere was a significant reduction in DRA (P=0.007) and CMT levels (P<0.001) in both study groups after treatment. When the two groups were compared, the differences in pretreatment values of DRA (P=0.001), DRV (P=0.017), CMT (P=0.039), and mean BCVA (P=0.00) were found to be statistically significant. Posttreatment changes in DRA (P=0.013) and mean CMT (P=0.010) were found to be factors related to VA recovery by logistic regression analysis.ConclusionOur findings reveal that ranibizumab treatment is associated with decrease in DRA, CMT, and significant improvement in VA recovery. Further, taking into account the cases in which VA was preserved, when needed, ranibizumab should be re-injected after the loading dose.

The clinical effects and mechanism of action of ranibizumab in treating myopic choroidal neovascularization

“…A great improvement in BCVA was found, along with a signi cantly decreased CMT measured by OCT and aqueous humor contents of VEGF-A, VEGF-D, and endoglin, but signi cantly decreased content of EGF after consecutive intravitreal injections of ranibizumab. The results were similar to those from another study on the effects of ranibizumab in AMD cases [25]. The concentrations of cytokines may be quantitative indicators of the effects of ranibizumab in patients with myopic CNV.…”

“…Ranibizumab (Lucentis; Novartis Pharma AG, Switzerland) is speci cally adopted to stop the active forms of VEGF-A [8] as a humanized, recombinant, monoclonal antibody fragment. Intravitreal injections of ranibizumab have demonstrated a curative effect on visual acuity improvement among patients with myopic CNV [9][10]. Further investigation is required to elucidate the clinical effects and mechanism of action of ranibizumab in the treatment of myopic CNV.…”

Real-World Effectiveness and Real-World Cost-Effectiveness of Intravitreal Aflibercept and Intravitreal Ranibizumab in Neovascular Age-Related Macular Degeneration: Systematic Review and Meta-Analysis of Real-World Studies

“…The authors compiled the VA gains reported by the individual RBZ studies to identify if there were significant differences/imbalances in the mean VA gain and in the clinical practice in RBZ studies completed both before and after 2015. The analysis of the individual data shows that the earlier studies (prior to 2015) report some of the highest and more consistent gains in visual acuity among the RBZ studies (Rothenbuehler et al [36], Gillies et al [41], Finger et al [43], Gungel et al [44], Inoue et al [45]). (See Appendix 1D in the supplementary material.)…”

“…1). After review, 24 observations from 23 studies were selected for inclusion in the meta-analysis (7 observations for intravitreally administered aflibercept [12-16, 34, 35] and 17 for RBZ [34,[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]) (Appendix 1 in the supplementary material). One study contributed more than one observation because it reported several subgroups, including both intravitreally administered aflibercept and RBZ [34].…”