Abstract

SA.16.07

12 months results of the PRONTO-scheme in the anti-VEGF therapy for AMD in clinical practice

Britta Elisabeth Heimes, Albrecht Lommatzsch, Jan Christian Goebel, Matthias Gutfleisch, Georg Spital, Meike Brigitte Zeimer, Daniel Pauleikhoff
Augenabteilung am St. Franziskus-Hospital, Münster

Objective
The anti-VEGF therapy is established in the treatment of exudative AMD. The effectiveness of the treatment is well documented by large phase III studies, but parameters for clinical application, monitoring and the assessment of prognosis and their treatment success over a longer period of time have to be defined.
Methods
We observed 128 patients with exudative AMD (104 occult CNV with recent disease progression, 24 class. CNV) during injection therapy (first 3 Inj., then according to the PRONTO scheme) with ranibizumab (Lucentis) and assessed angiography, best corrected visual acuity (VA), microperimetry (Nidek), OCT (Zeiss, Spectralis HRA) and the foveal autofluorescence (AF within a radius of 500 microns to the fovea, HRA) over a mean follow-up of 65 weeks.
Results
Initially 58.6% of the patients showed an increase of visual acuity after 3 months of Ø 0.13 logMAR. Despite re-treatment (Ø 4.9 Inj. in 12 months) most patients suffered in the long term follow-up a decrease of VA (Ø 0.16 logMAR). In line with this, a significant retinal re-thickening of Ø 49 microns occurred after 52 weeks compared to the initial reduction after 12 weeks. Especially in patients with initially changed AF, VA after 12 months decreased, while patients with initially normal AF remained stable in VA more frequently (p<0001).
Conclusions
An injection treatment in accordance to the PRONTO-scheme in clinical use showed in mean a subtle decrease of VA. A possible under-treatment and an initial injury to RPE seem to be negative predisposing factors.

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