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Anatomic response of occult choroidal neovascularization to intravitreal ranibizumab: a study by indocyanine green angiography

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

To investigate changes in indocyanine green angiography (ICGA) features of occult choroidal neovascularization (CNV) after intravitreal ranibizumab injections.

Methods

We reviewed the charts of all consecutive patients with newly diagnosed occult CNV secondary to age-related macular degeneration (AMD) treated by intravitreal ranibizumab. In all patients, optical coherence tomography (OCT) and ICGA were performed at baseline, after 3 months and 12 months.

Results

Fifty-one eyes of 44 patients (ten males, 34 females, mean age 77.8 ± 7.3 years) were included. Mean follow-up was 20.3 ± 6.2 months. During the first 12 months, patients received 5.5 ± 2.7 intravitreal ranibizumab injections. When compared with baseline, best-corrected visual acuity (BCVA) significantly improved at the 3-month follow-up visit (60.5 ±22.0 vs 50.9 ±20.7 letters, p = 0.04), and stabilized at 12-month visit (55.7 ±18.2 letters; p = 0.05). Central macular thickness (CMT) significantly improved during follow-up (229.0 ±54.7 μm vs 281.0 ±61.3 μm at baseline, p = 0.003). An overall stabilization was observed on ICGA in both the lesion area (5.27 ± 3.9 mm2 at baseline vs 4.60 ± 3.5 mm2 at month 12, p = 0.4), and greatest linear dimension (GLD 2.66 ± 1.2 mm at baseline vs 2.55 ± 1.0 mm at month 12, p = 0.3). Eight eyes (15.7%) showed CNV growth on ICGA (lesion area 3.98 ± 3.2 mm2 at baseline vs 4.3 ± 2.7 mm2 at month-12, p = 0.6; GLD 2.11 ± 1.0 mm at baseline vs 2.70 ± 0.8 mm at month-12, p = 0.05).

Conclusion

ICGA suggests that functional outcomes after intravitreal ranibizumab is related to CMT reduction rather than CNV regression.

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References

  1. Bressler NM (2004) Age-related macular degeneration is the leading cause of blindness. JAMA 291:1900–1901

    Article  PubMed  CAS  Google Scholar 

  2. Gass JD (1994) Biomicroscopic and histopathologic considerations regarding the feasibility of surgical excision of subfoveal neovascular membranes. Am J Ophthalmol 118:285–298

    PubMed  CAS  Google Scholar 

  3. Macular Photocoagulation Study Group (1991) Laser photocoagulation of subfoveal neovascular lesion in age-related macular degeneration: results of a randomized clinical trial. Arch Ophthalmol 109:1220–1231

    Article  Google Scholar 

  4. Macular Photocoagulation Study Group (1996). Occult choroidal neovascularization. Influence on visual outcome in patients with age-related macular degeneration. Arch Ophthalmol 114:400–412

    Article  Google Scholar 

  5. Lafaut BA, Bartz-Schmidt KU, Vanden Broecke C, Aisenbrey S, De Laey JJ, Heimann K (2000) Clinicopathological correlation in exudative age related macular degeneration: histological differentiation between classic and occult choroidal neovascularization. Br J Ophthalmol 84:239–243

    Article  PubMed  CAS  Google Scholar 

  6. Hermans P, Lommatzsch A, Bomfeld N, Pauleikhoff D (2003) Angiographichistological correlation of late exudative age-related macular degeneration. Ophthalmologe 100:378–383

    Article  PubMed  CAS  Google Scholar 

  7. Submacular Surgery Trials Research Group (2006). Comparison of 2D reconstructions of surgically excised subfoveal choroidal neovascularization with fluorescein angiographic features: SST report No. 15. Ophthalmology 113:279e1–279e5

    Google Scholar 

  8. Flower RW, Yannuzzi LA, Slakter JS (1997) History of indocyanine green angiography. In: Yannuzzi LA, Flower RW, Slakter JS (eds) indocyanine green angiography. Mosby, St Louis, pp 2–17

    Google Scholar 

  9. Hayashi K, de Laey JJ (1985) Indocyanine green angiography of submacular choroidal vessels in the human eye. Ophthalmologica 190:20–29

    Article  PubMed  CAS  Google Scholar 

  10. Hayashi K, de Laey JJ (1985) Indocyanine green angiography of choroidal neovascular membranes. Ophthalmologica 190:30–39

    Article  PubMed  CAS  Google Scholar 

  11. Destro M, Puliafito CA (1989) Indocyanine green videoangiography of choroidal neovascularization. Ophthalmology 96:846–853

    PubMed  CAS  Google Scholar 

  12. Guyer DR, Puliafito CA, Mones JM, Friedman E, Chang W, Verdooner SR (1992) Digital indocyanine-green angiography in chorioretinal disorders. Ophthalmology 99:287–291

    PubMed  CAS  Google Scholar 

  13. Yannuzzi LA, Slakter JS, Sorenson JA, Guyer DR, Orlock DA (1992) Digital indocyanine green videoangiography and choroidal neovascularization. Retina 12:191–223

    Article  PubMed  CAS  Google Scholar 

  14. Sorenson JA, Yannuzzi LA, Slakter JS, Guyer DR, Ho AC, Orlock DA (1994) A pilot study of digital indocyanine green videoangiography for recurrent occult choroidal neovascularization in age-related macular degeneration. Arch Ophthalmol 112:473–479

    Article  PubMed  CAS  Google Scholar 

  15. Slakter JS, Yannuzzi LA, Sorenson JA, Guyer DR, Ho AC, Orlock DA (1994) A pilot study of indocyanine green video- angiography-guided laser photocoagulation of occult choroidal neovascularization in age-related macular degeneration. Arch Ophthalmol 112:465–472

    Article  PubMed  CAS  Google Scholar 

  16. Yannuzzi LA, Hope-Ross M, Slakter JS, Guyer DR, Sorenson JA, Ho AC, Sperber DE, Freund KB, Orlock DA (1994) Analysis of vascularized pigment epithelial detachments using indocyanine green videoangiography. Retina 14:99–113

    Article  PubMed  CAS  Google Scholar 

  17. Chen Y, Wiesmann C, Fuh G, Li B, Christinger HW, McKay P, de Vos AM, Lowman HB (1999) Selection and analysis of an optimized anti-VEGF antibody: crystal structure of an affinity-matured Fab in complex with antigen. J Mol Biol 293:865–881

    Article  PubMed  CAS  Google Scholar 

  18. Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY; MARINA Study Group (2006) Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 355:1419–1431

    Article  PubMed  CAS  Google Scholar 

  19. Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S; ANCHOR Study Group (2006) Ranibizumab vs verteporfin for neovascular age-related macular degeneration. N Engl J Med 355:1432–1444

    Article  PubMed  CAS  Google Scholar 

  20. Querques G, Azrya S, Martinelli D, Berboucha E, Feldman A, Pece A, Coscas G, Soubrane G, Souied EH (2010) Ranibizumab for exudative age-related macular degeneration: 24-month outcomes from a single-centre institutional setting. Br J Ophthalmol 94:292–296

    Article  PubMed  Google Scholar 

  21. Regillo CD, Brown DM, Abraham P, Yue H, Ianchulev T, Schneider S, Shams N (2008) Randomized, double-masked, sham-controlled trial of ranibizumab for neovascular age-related macular degeneration: PIER Study year 1. Am J Ophthalmol 145:239–248

    Article  PubMed  CAS  Google Scholar 

  22. Kaiser PK, Blodi PA, Shapiro H, Acharya NR, MARINA Study Group (2007) Angiographic and optical coherence tomographic results of the MARINA study of ranibizumab in neovascular age-related macular degeneration. Ophthalmology 114:1868–1875

    Article  PubMed  Google Scholar 

  23. Keane PA, Liakopoulos S, Ongchin SC, Heussen FM, Msutta S, Chang KT, Walsh AC, Sadda SR (2008) Quantitative subanalysis of optical coherence tomography after treatment with ranibizumab for neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci 49:3115–3120

    Article  PubMed  Google Scholar 

  24. Kiss CG, Geitzenauer W, Simader C, Gregori G, Schmidt-Erfurth U (2009) Evaluation of ranibizumab-induced changes of high-resolution optical coherence tomographic retinal morphology and their impact on visual function. Invest Ophthalmol Vis Sci 50:2376–2383

    Article  PubMed  Google Scholar 

  25. Costagliola C, Semeraro F, Cipollone U, Rinaldi M, Della Corte M, Romano MR (2009) Changes in neovascular choroidal morphology after intravitreal bevacizumab injection: prospective trial on 156 eyes throughout 12-month follow-up. Graefes Arch Clin Exp Ophthalmol 247:1031–1037

    Article  PubMed  CAS  Google Scholar 

  26. Yoganathan P, Deramo VA, Lai JC, Tibrewala RK, Fastenberg DM (2006) Visual improvement following intravitreal bevacizumab (Avastin) in exudative age-related macular degeneration. Retina 26:994–998

    Article  PubMed  Google Scholar 

  27. Jo N, Mailhos C, Ju M, Cheung E, Bradley J, Nishijima K, Robinson GS, Adamis AP, Shima DT (2006) Inhibition of platelet-derived growth factor B signaling enhances the efficacy of anti-vascular endothelial growth factor therapy in multiple models of ocular neovascularization. Am J Pathol 168:2036–2053

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

Contributions to authors in each of these areas: Design and conduct of the study (GQ, EHS); collection, management, analysis (GQ, THCT, RF, LQ), and interpretation of the data (GQ, FB, EHS); and preparation (GQ, EHS), review, or approval of the manuscript (GQ, FB, EHS).

The principal investigator had full access to all the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Competing Interest

None declared

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Authors and Affiliations

  1. Department of Ophthalmology, University Paris Est Creteil, Centre Hospitalier Intercommunal de Creteil, 40 Avenue de Verdun, 94000, Creteil, France

    Giuseppe Querques, Raimondo Forte, Lea Querques & Eric H. Souied

  2. Department of Ophthalmology, Hôpital Saint Vincent de Paul, Lille, France

    Thi Ha Chau Tran

  3. Department of Ophthalmology, Hospital San Raffaele, University Vita Salute San Raffaele, Milan, Italy

    Lea Querques & Francesco Bandello

Authors
  1. Giuseppe Querques
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  2. Thi Ha Chau Tran
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  3. Raimondo Forte
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  4. Lea Querques
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  5. Francesco Bandello
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  6. Eric H. Souied
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Correspondence to Giuseppe Querques.

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The authors have no proprietary interest in the materials used in this study.

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Querques, G., Tran, T.H.C., Forte, R. et al. Anatomic response of occult choroidal neovascularization to intravitreal ranibizumab: a study by indocyanine green angiography. Graefes Arch Clin Exp Ophthalmol 250, 479–484 (2012). https://doi.org/10.1007/s00417-011-1831-5

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  • DOI: https://doi.org/10.1007/s00417-011-1831-5

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