The effects of ranibizumab injections on fluorescein angiographic findings and visual acuity recovery in age-related macular degeneration
Authors Gungel H, Osmanbasoglu O, Altan C, Baylancicek D, Basgil Pasaoglu I
Received 4 February 2014
Accepted for publication 13 March 2014
Published 19 May 2014 Volume 2014:8 Pages 981—988
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Hulya Gungel,1 Ozen Ayranci Osmanbasoglu,1 Cigdem Altan,2 Deniz Oygar Baylancicek,3 Isil Basgil Pasaoglu2
1Istanbul Education and Research Hospital, Eye Clinic, 2Beyoglu Eye Education and Research Hospital, 3Kudret Eye Hospital, Istanbul, Turkey
Aim: The 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 methods: This 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.
Results: There 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.
Conclusion: Our 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.
Keywords: vessel caliber, prognosis, central macular thickness, retinal vein diameter, retinal arteriole diameter
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