Visual acuity outcomes in ranibizumab-treated neovascular age-related macular degeneration; stratified by baseline vision.

BACKGROUND

Ranibizumab (Lucentis, Novartis, Basel, Switzerland) is currently indicated for use in neovascular age-related macular degeneration (NVAMD). This study assessed the real-life outcomes based on baseline visual acuity when treated with intravitreal ranibizumab on a three + pro re nata (PRN) dosing schedule for NVAMD.

DESIGN

This retrospective chart-review was conducted at King's College Hospital. The patients were stratified into three groups based on baseline Early treatment diabetic retinopathy study (ETDRS) letters: 27 with poor visual acuity (24-34 letters), 33 with intermediate visual acuity (35-54 letters) and 27 with good visual acuity (≥=55 letters).

METHODS

All patients received a three + PRN dosing schedule of ranibizumab injections (0.5 mg per 0.05 mL) based on changes in visual acuity and macular thickness on optical coherence tomography (OCT) and all patients completed 12-month follow up.

MAIN OUTCOME MEASURES

The mean change in visual acuity at 12 months in the three groups.

RESULTS

Mean gain in ETDRS letters at 12 months was +14.00 (P < 0.0001), +7.10 (P = 0.012) and +2.85 (P = 0.19), and mean number of injections was 5.30, 6.12 and 5.70 in the poor, intermediate and good baseline vision group, respectively, over the 12- month follow-up period.

CONCLUSIONS

Poor baseline visual acuity (24-34 ETDRS letters) is a predictor of maximum gain in visual acuity. However, eyes with better baseline visual acuity (55 letters) had a better final visual acuity.