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Five-year treatment outcomes following intravitreal ranibizumab injections for neovascular age-related macular degeneration in Japanese patients

  • Retinal Disorders
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Abstract

Purpose

To assess the real-world 5-year treatment outcomes of ranibizumab therapy in Japanese patients with neovascular age-related macular degeneration (AMD).

Methods

This was a retrospective, observational, and open-label effectiveness study that included 295 eyes. The participants were patients with treatment-naïve neovascular AMD who received intravitreal ranibizumab (IVR) monthly injection at least three times as the loading phase, followed by further injections as needed (pro re nata (PRN)) and follow-up assessments for 5 years. Outcomes were determined at least 5 years after the first ranibizumab injection.

Results

Mean logMAR best-corrected visual acuity (BCVA) at baseline was 0.52. The mean BCVA significantly improved after three loading injections; however, it declined gradually. The BCVA at 1 year was significantly better than the baseline BCVA, whereas the 3-year, 4-year, and 5-year BCVA values were significantly lower than the baseline values. The average central foveal thickness improved significantly from 366 ± 125 μm to 268 ± 134 μm (p < 0.0001). Macular atrophy was significantly more likely to occur in cases with classic choroidal neovascularization (CNV) than in cases with other AMD (p = 0.01).

Conclusions

IVR is well tolerated in eyes with AMD. However, a PRN regimen for AMD may have limited real-world effectiveness for long-term maintenance of improved visual acuity. Macular atrophy may occur more frequently in classic CNV. To maintain good vision, IVR treatment should be started earlier and performed continuously.

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Funding

This study was funded by the JSPS KAKENHI Grant Number (Kiban C 17K11454 (to Y.O.)).

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Authors and Affiliations

  1. Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Iori Wada, Yuji Oshima, Satomi Shiose, Kumiko Kano, Shintaro Nakao, Yoshihiro Kaizu, Shigeo Yoshida, Tatsuro Ishibashi & Koh-hei Sonoda

  2. Department of Ophthalmology, Fukuoka University Chikushi Hospital, Fukuoka, Japan

    Yuji Oshima

Authors
  1. Iori Wada
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  2. Yuji Oshima
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  3. Satomi Shiose
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  4. Kumiko Kano
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Corresponding author

Correspondence to Yuji Oshima.

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Conflict of interest

Author T.I. has received research grants from Bayer Yakuhin, Ltd., and Santen Pharmaceutical Co., Ltd. Author K.S. has received research grants from Santen Pharmaceutical Co., Ltd.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all the participants included in the study.

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Wada, I., Oshima, Y., Shiose, S. et al. Five-year treatment outcomes following intravitreal ranibizumab injections for neovascular age-related macular degeneration in Japanese patients. Graefes Arch Clin Exp Ophthalmol 257, 1411–1418 (2019). https://doi.org/10.1007/s00417-019-04361-8

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  • DOI: https://doi.org/10.1007/s00417-019-04361-8

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