Aim. To assess the significance of age, gender, baseline best corrected visual acuity, baseline macula thickness, and type and size of choroidal neovascularization in early morphological therapeutic response to ranibizumab treatment in patients with the wet form of age-related macular degeneration. Methods. From 09/2008 to 06/2013 we evaluated 1153 newly diagnosed, treatment-naïve patients treated with ranibizumab. Based on the morphological findings in the macula following the initial 3 injections of ranibizumab, the patients were divided into two groups based on active and inactive choroidal neovascularization. Results. After the initial 3 injections of ranibizumab, we examined the sample of 841 eyes with active CNV and 312 eyes with inactive CNV. In the inactive group, we found a statistically higher proportion of occult CNV (P < 0.001) and lower incidence of CNV greater than 5DA (P < 0.001) compared with the active group. We found no statistically significant difference in age, gender, baseline best corrected visual acuity, or baseline macula thickness between the inactive and active groups. Conclusion. Occult CNV and CNV smaller than 5DA are optimistic factors for a better morphological therapeutic response at the beginning of ranibizumab treatment.

Department of Ophthalmology Faculty of Medicine and Dentistry Palacky University 1 P Pavlova 6 775 20 Olomouc Czech Republic

Department of Ophthalmology Faculty of Medicine in Hradec Králové Charles University Prague and University Hospital in Hradec Králové Sokolská 581 500 03 Hradec Králové Czech Republic

Department of Ophthalmology University Hospital Jihlavská 340 20 625 00 Brno Czech Republic

Institute of Biostatistics and Analyses Faculty of Medicine and Faculty of Science Masaryk University Kamenice 126 3 625 00 Brno Czech Republic

Private Eye Clinic 5 Hůrkách 1296 10 158 00 Prague Czech Republic

Zobrazit více v PubMed

Bressler N. M., Bressler S. B., Fine S. L. Age-related macular degeneration. Survey of Ophthalmology. 1988;32(6):375–413. doi: 10.1016/0039-6257(88)90052-5. PubMed DOI

Rosenfeld P. J., Brown D. M., Heier J. S., et al. Ranibizumab for neovascular age-related macular degeneration. The New England Journal of Medicine. 2006;355(14):1419–1431. doi: 10.1056/NEJMoa054481. PubMed DOI

Holz F. G., Amoaku W., Donate J., et al. Safety and efficacy of a flexible dosing regimen of ranibizumab in neovascular age-related macular degeneration: the SUSTAIN study. Ophthalmology. 2011;118(4):663–671. doi: 10.1016/j.ophtha.2010.12.019. PubMed DOI

Sarks J. P., Sarks S. H., Killingsworth M. C. Morphology of early choroidal neovascularisation in age-related macular degeneration: correlation with activity. Eye. 1997;11(4):515–522. doi: 10.1038/eye.1997.137. PubMed DOI

Killingsworth M. C. Angiogenesis in early choroidal neovascularization secondary to age-related macular degeneration. Graefe's Archive for Clinical and Experimental Ophthalmology. 1995;233(6):313–323. doi: 10.1007/BF00200479. PubMed DOI

Gonzales C. R. VEGF Inhibition Study in Ocular Neovascularization (V.I.S.I.O.N) Clinical Trial Group Enhance defficacy associated with early treatment of neovascular age-related macular degeneration with pegaptanib sodium: an exploratory analysis. Retina. 2005;25:815–827. doi: 10.1097/00006982-200510000-00001. PubMed DOI