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

Authors

  • Robyn Troutbeck FRANZCO,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Roland Bunting FRANZCO,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Anton van Heerdon FRANZCO,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Melinda Cain RN,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Robyn Guymer FRANZCO

    Corresponding author
    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Competing/conflicts of interest: R Troutbeck and A van Heerdon were previous Novartis medical retinal fellows, and R Bunting is the current Novartis medical retinal fellow. R Guymer is on the Novartis Australia advisory board.

  • Funding sources: CERA receives Operational Infrastructure Support from the Victorian Government.

Professor Robyn Guymer, Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, Vic. 3002, Australia. Email: rhg@unimelb.edu.au

Abstract

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.

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