Medical Ophthalmology

Graefe's Archive for Clinical and Experimental Ophthalmology

, Volume 250, Issue 10, pp 1467-1476

First online:

EXTEND III: Efficacy and safety of ranibizumab in South Korean and Taiwanese patients with subfoveal CNV secondary to AMD

  • Oh-Woong KwonAffiliated withThe Retina Center, Nune Eye Hospital
  • , Fenq Lih LeeAffiliated withTaipei Veterans General Hospital No. 201 Email author 
  • , Hum ChungAffiliated withDepartment of Ophthalmology, Seoul National University Hospital
  • , Chi-Chun LaiAffiliated withChang-Gung Memorial Hospital
  • , Shwu-Jiuan SheuAffiliated withKaohsiung Veterans General Hospital, Kaohsiung, National Yang-Ming University
  • , Young-Hee YoonAffiliated withDepartment of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan
  • , on behalf of the EXTEND III study group

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The purpose of this study was to investigate the efficacy and safety of intravitreal ranibizumab 0.5 mg in South Korean and Taiwanese patients with subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).


This was a 12-month, open-label, single-arm, multi-center, phase III study. Ninety-five patients (Taiwanese: 51; South Korean: 44) were included in the study. Key outcome measures assessed included: mean change in best-corrected visual acuity (BCVA) from baseline to months 4 (primary endpoint) and 12 (secondary endpoint); other secondary endpoints comprising categorized mean change in BCVA from baseline at month 4 and month 12, mean change in BCVA from baseline at month 4 and month 12 per baseline characteristics; and incidence of ocular and non-ocular adverse events and serious adverse events (SAEs) at month 12.


The mean BCVA change improved significantly (p < 0.0001) from baseline to both month 4 (+9.3 letters) and month 12 (+10.1 letters). At month 12, the proportion of patients who gained ≥5, 10, or 15 letters from baseline was 75.8%, 54.7%, and 32.6% respectively. Total and CNV lesion area significantly decreased from baseline (p < 0.0001). About 57% of patients showed complete absence of fluorescein leakage at month 12. Mean change from baseline visual acuity scores also increased significantly over time for all subgroups. At month 12, ocular SAEs occurred in 2.1% of patients (out of which one patient [1.1%] experienced endophthalmitis) and 16.8% of patients experienced non-ocular SAEs. There were no deaths reported during the study.


Consistent with previous studies in Caucasian and Japanese populations, EXTEND III confirms that monthly intravitreal injections of ranibizumab 0.5 mg administered over 12 months is effective and well-tolerated in South Korean and Taiwanese patients with subfoveal CNV secondary to AMD.


Choroidal neovascularization Age-related macular degeneration Best-corrected visual acuity Intravitreal ranibizumab Fluorescein leakage