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

  • Iori Wada
  • Yuji OshimaEmail author
  • Satomi Shiose
  • Kumiko Kano
  • Shintaro Nakao
  • Yoshihiro Kaizu
  • Shigeo Yoshida
  • Tatsuro Ishibashi
  • Koh-hei Sonoda
Retinal Disorders



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


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.


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).


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.


Age-related macular degeneration Ranibizumab Long-term treatment Pro re nata treatment Macular atrophy 



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

Compliance with ethical standards

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.

Informed consent

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


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Iori Wada
    • 1
  • Yuji Oshima
    • 1
    • 2
    Email author
  • Satomi Shiose
    • 1
  • Kumiko Kano
    • 1
  • Shintaro Nakao
    • 1
  • Yoshihiro Kaizu
    • 1
  • Shigeo Yoshida
    • 1
  • Tatsuro Ishibashi
    • 1
  • Koh-hei Sonoda
    • 1
  1. 1.Department of Ophthalmology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  2. 2.Department of OphthalmologyFukuoka University Chikushi HospitalFukuokaJapan

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