Role of intraretinal and subretinal fluid on clinical and anatomical outcomes in patients with neovascular age-related macular degeneration treated with bimonthly, treat-and-extend and as-needed ranibizumab in the In-Eye study.
Aged
Angiogenesis Inhibitors
/ administration & dosage
Dose-Response Relationship, Drug
Drug Administration Routes
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Intravitreal Injections
Macula Lutea
/ diagnostic imaging
Male
Prospective Studies
Ranibizumab
/ administration & dosage
Subretinal Fluid
Time Factors
Tomography, Optical Coherence
/ methods
Vascular Endothelial Growth Factor A
/ antagonists & inhibitors
Visual Acuity
Wet Macular Degeneration
/ diagnosis
age-related macular degeneration
fixed bimonthly
intraretinal fluid
intravitreal anti-VEGF
neovascular age-related macular degeneration
pro re nata
ranibizumab
subretinal fluid
treat-and-extend
Journal
Acta ophthalmologica
ISSN: 1755-3768
Titre abrégé: Acta Ophthalmol
Pays: England
ID NLM: 101468102
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
13
05
2020
accepted:
18
01
2021
pubmed:
16
3
2021
medline:
15
1
2022
entrez:
15
3
2021
Statut:
ppublish
Résumé
To assess the effect of fluid status at baseline (BL) and at the end of the loading phase (LP) of three different ranibizumab regimens: treat-and-extend (T&E), fixed bimonthly (FBM) injections and pro re nata (PRN), in patients with neovascular age-related macular degeneration (nAMD). Post hoc analysis of the In-Eye study (phase IV clinical trial). Patients were randomized 1:1:1 to the three study arms and were treated accordingly. The presence and type of fluid, intraretinal fluid (IRF) or subretinal fluid (SRF) and the anatomical and visual outcomes were analysed. Best-corrected visual acuity (BCVA), the mean change from baseline BCVA (BL BCVA), and the proportion of eyes gaining more than 15 letters or losing more than five letters were analysed. Morphological characteristics including the subtype of choroidal neovascular membrane and the development of atrophy and fibrosis were also evaluated. Patients with SRF at LP had better visual outcomes than patients with IRF. The persistence of SRF did not affect the mean change from BL BCVA among the three treatment regimens. However, in patients with IRF mean change from BL BCVA was significantly lower in the FBM group. The presence of IRF at BL and at the end of the loading phase was associated with the development of fibrosis at the end of the study; this result was contrary to that observed for patients with SRF. While SRF is compatible with good visual and anatomical outcomes, IRF leads to worse results in patients with nAMD; our results suggest that patients with IRF have better outcomes when individualized treatment regimens are used (PRN or T&E) in contrast with a FBM regimen.
Substances chimiques
Angiogenesis Inhibitors
0
Vascular Endothelial Growth Factor A
0
Ranibizumab
ZL1R02VT79
Types de publication
Clinical Trial, Phase IV
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
861-870Subventions
Organisme : Instituto de Salud Carlos III
Investigateurs
Marta S Figueroa
(MS)
Maribel Fernández Rodríguez
(MF)
Josep García Arumí
(JG)
Pedro Amat
(P)
Vissum Alicante
(V)
Alfredo García-Layana
(A)
Lluís Arias Barquet
(LA)
Jose María Ruiz Moreno
(JMR)
Javier Ascaso Puyuelo
(JA)
Félix Armada Maresca
(FA)
Enrique Cervera Taulet
(EC)
María Isabel López Gálvez
(MIL)
Ramón Torres Imaz
(RT)
Estanislao Gutiérrez Sánchez
(EG)
Luis Mateo Cordovés Dorta
(LMC)
Eduardo Esteban González
(EE)
Sara Velilla Osés
(SV)
Santiago Abengoechea Hernández
(SA)
Miguel Ruíz Miguel
(MR)
Erneesto Basauri Rementería
(EB)
Rafael Caballos Castilla
(RC)
Jacinto Villalvilla Castillo
(JV)
Lorenzo López Guajardo
(LL)
Roberto Gallago Pinazo
(RG)
José Javier Araiz Iribarren
(JJA)
Laura Rodríguez García
(LR)
Francisco Cabrera López
(FC)
José Antonio López Garrido
(JAL)
María Lafuente López-Herrera
(ML)
María Socorro Alforja Castiella
(MSA)
Óscar Ruíz Moreno
(ÓR)
Nerea Martínez Alday
(NM)
Álvaro Fernández-Vega Sanz
(ÁF)
José García Campos
(JG)
Maria Hernandez
(M)
Sara Llorente
(S)
Onintza Sayar
(O)
Esther Oyaga Iriarte
(EO)
Informations de copyright
© 2021 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
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