Abstract

P 276

Functional and morphological outcome after ranibizumab upload in the treatment of neovascular age-related macular degeneration in clinical routine.

Mathias Maier, Nikolaus Feucht, Sarah Pfrommer, Amelie Ratschek, Christoph Winkler von Mohrenfels, Chris P. Lohmann
Augenklinik, Klinikum rechts der Isar, Technische Universität München, München

Objective
To evaluate the functional and morphological effect in clinical routine treatment during upload with ranibizumab (0,5mg) in patients with neovascular age-related macular degeneration (AMD).
Methods
In a clinical study 238 patients (238 eyes) with neovascular age-related macular degeneration were treated with three monthly injections of ranibizumab. 151 patients (63,4%) were untreated, 87 patients (36,6%) had prior treatment. Before and one month after the third injection visual acuity, OCT examination and fluorescein angiography (FA) were performed.
Results
We found stabilization of visual acuity in 227 patients (95%), but no statistically significant improvement (VA baseline: 20/63, after 3 months 20/63). OCT examination showed a significant mean reduction of foveal thickness of 22,9µm (Baseline: 277,4μm, after 3 months: 254,4μm ). Fluorescein angiography displayed stabilization of lesion size and a significant reduction of  leckage compared to baseline.136 patients (57,1%) needed further therapy after the upload phase. There was no significant correlation between visual acuity and morphological change in OCT or fluorescein angiography. We found no change in choroideal perfusion but 5 RPE-rips.
Conclusions
Intravitreal injection of ranibizumab during the upload phase was well tolerated and safe. In 227 patients (95 %) visual acuity was stabilized. We found no statistically significant correlation between functional and morphological outcome. It is unclear why there was no initial improvement like in other studies (MARINA, ANCHOR). Further studies are necessary to evaluate the outcome in clinical routine treatment.

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