INTRAVITREAL RANIBIZUMAB FOR EXUDATIVE AGE-RELATED MACULAR DEGENERATION WITH GOOD BASELINE VISUAL ACUITY

In Brief Purpose: To clarify the efficacy of ranibizumab for treating age-related macular degeneration in patients with baseline visual acuity exceeding 20/40. Methods: We retrospectively reviewed 40 eyes of Japanese patients with age-related macular degeneration (32 men, 8 women) treated with intravitreal injections of ranibizumab (0.5 mg/0.05 mL) (ranibizumab group). We compared the results with observation of 52 eyes (control group). All patients were followed-up for at least 12 months. Results: In the ranibizumab group, the mean logarithm of the minimum angle of resolution best-corrected visual acuity (Snellen equivalent) with typical age-related macular degeneration (22 eyes) and polypoidal choroidal vasculopathy (18 eyes) statistically significantly (P < 0.0001, P = 0.015, respectively) improved from 0.17 (20/29) and 0.14 (20/28) at baseline to 0.07 (20/24) and 0.07 (20/24) at Month 12, respectively (mean numbers of treatments, 4.6 and 4.9). The central retinal thickness decreased from 262 ± 105 μm at baseline to 187 ± 62 μm at Month 12 in the ranibizumab group. In the control group, the mean logarithm of the minimum angle of resolution best-corrected visual acuity in eyes with typical age-related macular degeneration (19 eyes) and polypoidal choroidal vasculopathy (33 eyes) statistically significant (P = 0.017, P = 0.023, respectively) declined from 0.08 (20/24) and 0.10 (20/25) at baseline to 0.18 (20/30) and 0.23 (20/34) at Month 12, respectively. Conclusion: Intravitreal ranibizumab maintained or improved visual acuity and anatomic changes in patients with age-related macular degeneration with better than 20/40 visual acuity. This study shows that intravitreal ranibizumab was effective for maintaining or improving visual acuity and the anatomic changes in patients with age-related macular degeneration with baseline visual acuity exceeding 20/40 (0.5 decimal visual acuity). Visual outcomes in eyes treated with ranibizumab were statistically significant better than outcomes in control eyes.