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Introduction : Age Related Macular Degeneration (AMD) stills the leading cause of blindness in developing countries for age 50 and above, increasing along higher life expectations.Anti- VEGF is the mainstay management for exudative AMD and able to reduce the central retinal thickness (CRT) and to increase the visual outcome. The aim of this study is to correlate between CRT and visual outcome in exudative AMD post intravitreal ranibizumab injection loading doses in Soetomo general academic hospital, Surabaya
Methods : This was a retrospective, cross sectional study. Fourty two eyes who met inclusion criterias were received monthly loading doses of 0.5 mg Ranibizumab intravitreal injection for three consequtives months. Baseline visual acuity (BCVA) was measured with Snellen Chart converted to LogMAR, CRT was measured by SD-OCT. Parameters was measured before the first injection and after completed three months injections.
Result : Fourty two eyes were composed by 59.5% male and 40.5% female with higher incidence in 61-70 years old (47.6%). Mean BCVA were 0.831 before and 0.624 after injection of serial Ranibizumab. Mean CRT were 346.9 and 254.2 µm before and after injection respectively. There was significant comparison between CRT and BCVA (p=0.00) & no correlation between CRT and BCVA before and after injection of Ranibizumab loading doses (p=0.418 & p=0.275)
Conclusion : There were no correlation statistically between CRT and BCVA before and after injection of loading doses Ranibizumab intravitreal in exudative AMD. Further studies may be needed to prove the etiology of this tendencies.
exudative age related macular degeneration; ranibizumab; anti-VEGF
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2. Brar, V. S., Law, S. K., Lindsey, J. L., Mackey, D. A., Schultze, R. L., Singh, R. S. J., Silverstein, E. 2019. The Eye. In: Fundamentals and Principles of Ophthalmology. Basic and Clinical Science Course 2019 - 2020. American Academy of Ophthalmology. San Fransisco. 119 - 138.
3. McCannel, C. A., Berrocal, A. M., Holder, G. E., Kim, S. J., Leonard, B. C., Rosen, R. B., Spaide, R. F., Sun, J. K. 2019. Basic Anatomy. In: Retina and Vitreous. Basic and Clinical Science Course 2019 - 2020. American Academy of Ophthalmology. San Fransisco. 31 - 47.
4. Regatieri, C. V., L. Branchini, J.S. Duker. 2011. The role of spectral-domain OCT in the diagnosis and management of neovascular age-related macular degeneration. Ophthalmic Surg Lasers Imaging. 42. 1–18. doi: 10.3928/15428877-20110627-05.
5. Michalewski, J., J. Nawrocki, B. Izdebski, Z. Michalewska. 2014. Morphological changes in spectral domain optical coherence tomography guided bevacizumab injections in wet age-related macular degeneration, 12-months results. Ind J Ophth. 62(5), 554–560. doi: 10.4103/0301-4738.133485.
6. Sayed, K. M., T. Naito, T. Nagasawa, T. Katome, Y. Mitamura. 2011. Early visual impacts of optical coherence tomographic parameters in patients with age-related macular degeneration following the first versus repeated Ranibizumab injection. Graefes Arch Clin Exp Ophthalmol. 249(10)1449–1458. doi: 10.1007/s00417-011-1672-2.
7. Kato, A., T. Yasukawa, Y. Ogura. 2014. Antivascular endothelial growth factor therapies for neovascular age-related macular degeneration: Search for the optimized treatment regimen.Taiw J Ophthalmol. 4(2014). 3-8. doi: 10.1016/j.tjo.2013.12.003
8. Sizmaz, S., C. Kucukerdonmez, A. Kal, E.Y. Pinarci, H. Canan, G. Yilmaz. 2014. Retinal and choroidal thickness changes after single anti-VEGF injection in neovascular age-related macular degeneration: Ranibizumab vs bevacizumab. Eur J Ophthalmol. 24(6). 904–910. doi: 10.5301/ejo.5000478.
9. McCannel, C. A., Berrocal, A. M., Holder, G. E., Kim, S. J., Leonard, B. C., Rosen, R. B., Spaide, R. F., Sun, J. K. 2019. Basic Anatomy. In: Retina and Vitreous. Basic and Clinical Science Course 2019 - 2020. American Academy of Ophthalmology. San Fransisco. 31 - 47.
10. Yonekawa, Y. and Kim, I.K. 2015. Clinical Characteristics and Current Treatment of Age-Related Macular Degeneration. Cold Spring Harb Perspect Med. doi: 10.1101/cshperspect.a017178
11. Kamao, H., K. Goto, K. Matsuno., K. Mizukawa, A. Miki, J. Kiryu. 2021. Clinical Characteristics of Neovascular Age-Related Macular Degeneration without Typical. Hindawi J. Ophthalmol. 2021,1-8. doi: 10.1155/2021/6683532
12. Wong, W. L., Su, X., Li, X., Cheung, C. M. G., Klein, R., Cheng, C.-Y., & Wong, T. Y. 2014. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. The Lancet Global Health, 2(2), e106–e116. doi:10.1016/s2214-109x(13)70145-1
13. Ho, A.C., Kleinman , D.M., Lum, F.C., Heier J.S., Lindstrom ,R.L., Orr, S.C., Chang G.C., Smith, E.L., Pollack J.S. 2020. Baseline Visual Acuity at Wet AMD Diagnosis Predicts Long-Term Vision Outcomes: An Analysis of the IRIS Registry. Ophthalmic Surg Lasers Imaging Retina. 2020(51):633-639. doi: 10.3928/23258160-20201104-05
14. Gale, R., Korobelnik, J.-F., Yang, Y., & Wong, T. Y. 2016. Characteristics and Predictors of Early and Delayed Responders to Ranibizumab Treatment in Neovascular Age-Related Macular Degeneration: A Retrospective Analysis from the ANCHOR, MARINA, HARBOR, and CATT Trials. Ophthalmologica, 236(4), 193–200. doi:10.1159/000451065
15. Reznicek, L., Muhr, J., Ulbig, M., Kampik, A., Mayer, W. J., Haritoglou, C., … Wolf, A. 2014. Visual acuity and central retinal thickness: fulfilment of retreatment criteria for recurrent neovascular AMD in routine clinical care. British Journal of Ophthalmology, 98(10), 1333–1337. doi:10.1136/bjophthalmol-2013-304399
16. De Almeida, N. A. and O. F. de Souza. 2018. Early changes in macular optical coherence tomography parameters after Ranibizumab intravitreal injection in patients with exsudative age-related macular degeneration, Int J Retin Vitr. 4(1), 1–5. doi: 10.1186/s40942-018-0109-z.
17. Ou, W. C., Brown, D. M., Payne, J. F., & Wykoff, C. C. 2017. Relationship Between Visual Acuity and Retinal Thickness During Anti–Vascular Endothelial Growth Factor Therapy for Retinal Diseases. American Journal of Ophthalmology, 180, 8–17. doi:10.1016/j.ajo.2017.05.014
18. Puell, M. C., Hurtado-Ceña, F. J., Pérez-Carrasco, M. J., & Contreras, I. 2020. Association between central retinal thickness and low luminance visual acuity in early age-related macular degeneration. European Journal of Ophthalmology, 112067212096874. doi:10.1177/1120672120968740
19. Danis, R. P., Sadda, S., Jiao, J., Li, X.-Y., & Whitcup, S. M. (2016). Relationship between retinal thickness and visual acuity in eyes with retinal vein occlusion treated with dexamethasone implant. Retina, 36(6), 1170–1176. doi:10.1097/iae.0000000000000851