Benefit of Four Years of Intravitreal Ranibizumab for Neovascular AMD
Researchers in the UK sought to analyze the benefit of intravitreal ranibizumab over four years for patients with neovascular age-related macular degeneration (AMD).
In their retrospective case note review of all patients who started treatment between August 2007 and September 2009 in their unit, minimum follow-up two years, maximum four years, the main outcome measures were: numbers of patients with different levels of vision; changes in visual acuity; number of treatments and numbers remaining under follow-up.
They reported that 1,086 eyes of 1,017 patients received treatment. They also noted that numbers of patients remaining under follow-up were 892/1,017 (87.71%) at 12 months, 730/1,017 (71.78%) at 24 months, 468/730 (64.11%) at 36 months and 110/217 (50.69%) at 48 months. The main reasons for patients no longer being under follow-up were the consequences of old age or transfer of care. According to the researchers, 50% of patients had 6/18 or better over four years. They documented that patients received on average 5.79 ± 2.53, 9.15 ± 3.79, 11.22 ± 4.92 and 13.7 ± 7.84 injections by 12, 24, 36 and 48 months, respectively.
They suggest that the numbers of patients with a particular level of vision may best reflect the actual benefit of AMD treatment provided by a service. Long-term follow-up is required, as only 72/730 (10%) had been discharged at 36 months, half of whom had good vision of greater than 60 letters. Additionally, 83% and 65% of patients needed treatment in the third and fourth year. Follow-up may be for the rest of the patients' life or at some point they may no longer be well enough to attend.