Ranibizumab and exudative age-related macular degeneration: 5-year multicentric functional and anatomical results in real-life practice

Purpose - The goal of this study was to evaluate five year functional and anatomical outcomes of wet AMD patients treated with ranibizumab according to a pro re nata (PRN) regimen in real-life practice. Methods. - A retrospective, multicentric chart review of 201 eyes of 201 patients who underwent their first ranibizumab intravitreal injection (IVT) between January 1, 2007 and December 31, 2008 was performed. Best-corrected visual acuity (BCVA), central macular thickness (CMT) on SD-OCT, number of IVT and follow-up visits were collected at baseline and during the entire follow-up period of 5 years. Results. - Mean BCVA at baseline was 52.3 +/- 16.5 letters. Mean BCVA change from baseline was respectively +2.8, +2.5, +1.8, -0.6 at 1, 2, 3, 4 years of follow-up. At year 5, 43% of eyes had a stable or improved letter score (>= 0 letter gain), whereas 29% declined by 15 letters or more, with an overall significant mean decline of 2.8 letters (P < 0.05). No correlation was observed between final visual outcome and age, baseline BCVA, type of neovascularization, naive status, number of IVT or number of follow-up visits. On SD-OCT, mean CMT was 293 +/- 96 mu m at baseline and was significantly reduced compared to baseline at each year end-point (P < 0.005). The mean number of IVT was 15 +/- 10.4 at year 5, with 55% of eyes still being under active treatment. Conclusion. - PRN ranibizumab in real-life practice improved or stabilized visual acuity over 4 years. During the 5th year, progressive decline of visual acuity was observed. (C) 2016 Elsevier Masson SAS. All rights reserved.