Long-Term Effect of Intravitreal Ranibizumab Injection on Choroidal Neovascularization in Age-Related Macular Degeneration

Hyo Ju Jang; Su Jeong Song; Jeong Hoon Bae

doi:10.3341/jkos.2013.54.9.1359

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Jang, Song, and Bae: Long-Term Effect of Intravitreal Ranibizumab Injection on Choroidal Neovascularization in Age-Related Macular Degeneration

Original Article

J Korean Ophthalmol Soc 2013;54(9):1359-1364.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.9.1359

Long-Term Effect of Intravitreal Ranibizumab Injection on Choroidal Neovascularization in Age-Related Macular Degeneration

Hyo Ju Jang, MD, Su Jeong Song, MD, Jeong Hoon Bae, MD

Department of Ophthalmology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Address reprint requests to Su Jeong Song, MD Department of Ophthalmology, Kangbuk Samsung Medical Center, #29 Saemunan-ro, Jongno-gu, Seoul 110-746, Korea Tel: 82-2-2001-2250~1, Fax: 82-2-2001-2262 E-mail: eye-su@hanmail.net

Received 10 November 20123 April 2013 Accepted 20 June 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate long-term efficacy and safety of intravitreal ranibizumab on choroidal neovascularization (CNV) in age-related macular degeneration (AMD) in Korean patients over a 2-year period.

Methods

Twenty-three eyes of 23 patients who underwent intravitreal ranibizumab injection for secondary CNV in AMD were followed up more than 2 years, and their records were retrospectively investigated. The best corrected visual acuity (BCVA), central macular thickness (CRT) were compared at baseline and at 6, 12, 18 and 24 months after injection.

Results

The mean BCVA (log MAR) was 0.58 ± 0.36, 0.54 ± 0.49, 0.59 ± 0.49, 0.64 ± 0.51, and 0.61 ± 0.51 at baseline, 6, 12, 18 and 24 months, respectively (p = 0.332, p = 1.000, p = 0.670, p = 0.697). The mean CRT was 283.75 ± 61.41 μ m, 239.93 ± 53.12 μ m, 244.89 ± 47.44 μ m, 246.36 ± 55.78, and 244.70 ± 54.86 at baseline, 6, 12, 18 and 24 months, re-spectively (p = 0.009, p = 0.036, p = 0.01, p = 0.015). The mean number of injection was 5.96 ± 2.93 over a 2-year period.

Conclusions

In Korean patients who underwent intravitreal ranibizumab injection for secondary CNV in AMD, long-term efficacy in diminishing CRT was evident. However, long-term efficacy in increasing visual acuity was not observed.

Keywords: Age-related macular degeneration, Choroidal neovascularization, Ranibizumab

References

1. Friedman DS, O'Colmain BJ, Muñoz B. . Prevalence of age-re-lated macular degeneration in the United States. Arch Ophthalmol. 2004; 122:564–72.

2. Augood C, Fletcher A, Bentham G. . Methods for a pop-ulation-based study of the prevalence of and risk factors for age-re-lated maculopathy and macular degeneration in elderly European populations: the EUREYE study. Ophthalmic Epidemiol. 2004; 11:117–29.

3. Resnikoff S, Pascolini D, Etya'ale D. . Global data on visual impairment in the year 2002. Bull World Health Organ. 2004; 82:844–51.

4. Au Eong KG. Age-related macular degeneration: an emerging challenge for eye care and public health professionals in the Asia Pacific region. Ann Acad Med Singapore. 2006; 35:133–5.

5. Kliffen M, Sharma HS, Mooy CM. . Increased expression of angiogenic growth factors in age-related maculopathy. Br J Ophthalmol. 1997; 81:154–62.

6. Otani A, Takagi H, Oh H. . Vascular endothelial growth factor family and receptor expression in human choroidal neovascular membranes. Microvasc Res. 2002; 64:162–9.

7. Rakic JM, Lambert V, Devy L. . Placental growth factor, a member of the VEGF family, contributes to the development of choroidal neovascularization. Invest Ophthalmol Vis Sci. 2003; 44:3186–93.

8. Rosenfeld PJ, Brown DM, Heier JS. . Ranibizumab for neo-vascular age-related macular degeneration. N Engl J Med. 2006; 355:1419–31.

9. Brown DM, Kaiser PK, Michels M. . Ranibizumab versus ver-teporfin for neovascular age-related macular degeneration. N Engl J Med. 2006; 355:1432–44.

10. Kwon OW, Lee FL, Chung H. . EXTEND III: Efficacy and safety of ranibizumab in South Korean and Taiwanese patients with subfoveal CNV secondary to AMD. Graefes Arch Clin Exp Ophthalmol. 2012; 250:1467–76.

11. Fung AE, Lalwani GA, Rosenfeld PJ. . An optical coherence tomography-guided, variable dosing regimen with intravitreal ra-nibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol. 2007; 143:566–83.

12. Kang SB, Cho WK, Roh YJ. The efficacy of ranibizumab for cho-roidal neovascularization in age-related macular degeneration. J Korean Ophthalmol Soc. 2009; 50:725–30.

13. Ferrara N, Damico L, Shams N. . Development of ranibizu-mab, an anti-vascular endothelial growth factor antigen binding fragment, as therapy for neovascular age-related macular degeneration. Retina. 2006; 26:859–70.

14. Gaudreault J, Fei D, Rusit J. . Preclinical pharmacokinetics of Ranibizumab (rhuFabV2) after a single intravitreal administration. Invest Ophthalmol Vis Sci. 2005; 46:726–33.

15. Tano Y, Ohji M; EXTEND-I Study Group. Long-term efficacy and safety of ranibizumab administered pro re nata in Japanese patients with neovascular age-related macular degeneration in the EXTEND-I study. Acta Ophthalmol. 2011; 89:208–17.

16. Holz FG, Amoaku W, Donate J. . Safety and efficacy of a flexi-ble dosing regimen of ranibizumab in neovascular age-related macular degeneration: the SUSTAIN study. Ophthalmology. 2011; 118:663–71.

17. Rosa RH Jr, Davis JL, Eifrig CW. Clinicopathologic reports, case reports, and small case series: clinicopathologic correlation of idio-pathic polypoidal choroidal vasculopathy. Arch Ophthalmol. 2002; 120:502–8.

18. Gomi F, Sawa M, Sakaguchi H. . Efficacy of intravitreal bev-acizumab for polypoidal choroidal vasculopathy. Br J Ophthalmol. 2008; 92:70–3.

Table 1.

Patients’ characteristics at baseline, 6, 12, 18 and 24 months

Characteristics	Value
Number of eyes (patients)	23 (23)
Age (years)	66.8 ± 7.8
Sex (M:F)	14 : 9
IOP (mm Hg)	13.4 ± 2.9
Classic CNV / Occult CNV	4 / 19
Number of injection	5.96 ± 2.93
Baseline mean BCVA (log MAR)	0.58 ± 0.36
Baseline mean central macular thickness (μ m)	283.75 ± 61.41
Baseline size of lesion (DA*)	3.35 ± 2.94 (0.26-12.37)

Values are presented as mean ± SD.

SD = standard deviation; IOP = intraocular pressure; CNV = choroidal neovascularization; BCVA = best corrected visual acuity; log MAR = logarithm of the minimum angle of resolution.

^* Optic-disc area.

Table 2.

Mean changes in best corrected visual acuity from baseline after intravitreal ranibizumab injection. Best corrected visual acuity decreased at 12, 18, 24 months

	Baseline	6th months	12th months	18th months	24th months
Visual acuity *	0.58 ± 0.36	0.54 ± 0.49	0.59 ± 0.49	0.64 ± 0.51	0.61 ± 0.51
p-value*		0.332	1.000	0.670	0.697

Values are presented as mean ± SD.

SD = standard deviation.

^* Wilcoxon signed ranks test.

Table 3.

Mean changes in central macular thickness from baseline after intravitreal ranibizumab injection. There was statistically significant improvement of central macular thickness after 6, 12, 18, 24 months

	Baseline	6th months	12th months	18th months	24th months
Central macular thickness (μ m)	283.75 ± 61.41	239.93 ± 53.12	244.89 ± 47.44	246.36 ± 55.78	244.70 ± 54.86
p-value*		0.009	0.036	0.010	0.015

Values are presented as mean ± SD.

SD = standard deviation.

^* Wilcoxon signed ranks test.

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