Objective T o observe the efficacy and safety of intravitreal injection of ranibizumab (Lucentis) for 12 consecutive months treating exudative age-related macular degeneration (EAMD). Methods This is an open and prospective study without control trial. Twenty-two eyes from 22 patients (18 males and 4 females) with EAMD diagnosed by fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were enrolled in this study. The patients aged from 46 to 79 years with the mean of 68.2 plusmn;9.3 years. All of the patients received intravitreal injection of ranibizumab (0.5 mg, 0.05 ml) once a month for 12 consecutive months. The best-corrected visual acuity (BCVA) was obtained using the international standard visual acuity chart (converted into logMAR for statistical analysis). Central retinal thickness (CRT) was measured by optical coherence tomography (OCT) before and after each monthly treatment. Intraocular pressure (IOP) was measured using non-contact tonometry before treatment and 1 hour and 1 day after treatment. FFA and ICGA were performed every 3 months. The BCVA was 0.01 -0.9 with the average of 0.26 plusmn;0.22. The average logMAR BCVA was 0.76 plusmn;0.44, the CRT was 182-559 mu;m with the mean of (302.62 plusmn;90.18) mu;m, and the IOP was normal before treatment. Only 13 of 22 patients completed 12 months of follow-up. The BCVA, CRT and IOP after treatment were compared with baseline using paired t test. Results Of all the 22 patients, the mean logMAR BCVA at 1 and 3 months after treatment were 0.52 plusmn;0.32 and 0.37 plusmn;0.27 respectively, both of which were significantly different compared with before treatment (t=4.518, 6.237;P＜0.05). Of the 13 patients, the mean logMAR BCVA at 1, 3 and 12 months after treatment was 0.51 plusmn;0.34, 0.35 plusmn;0.26, 0.34 plusmn;0.30 respectively. All of these measures were significantly different compared with 0.74 plusmn;0.37 before treatment (t=3.443, 5.438, 4.756;P＜0.05) . The mean CRT at 1, 3 and 12 months after treatment were (228.85 plusmn;54.93), (231.00 plusmn;38.94) and (262.92 plusmn;70.48) mu;m. There were significant differences among before and 1, 3 months after treatment (t=2.914, 3.199;P＜0.05), but not between before and 12 months after treatment (t=1.408, P＞0.05). The first 3 injections contributed to the most BCVA gain with 6 patients prime; BCVA increasing from 0.1- 0.5 to 0.5 or above. The greatest CRT reduction was obtained at 1 month after the first injection. IOP increased 1 hour after treatment and recovered within 1 day. No intravitreal injection-related side effects such as endophthalmitis were observed during the follow-up period. Conclusions Monthly intravitreal injections of ranibizumab may improve BCVA and macular edema. There was no adverse event during the follow-up duration.
Citation： 李晓陵,何守志,王炜,崔霞,张鲲,王宁,张卯年. Clinical observation of intravitreal injection of ranibizumab for 12 consecutive months treating exudative age-related macular degeneration. Chinese Journal of Ocular Fundus Diseases, 2011, 27(6): 515-519. doi: Copy