J Korean Ophthalmol Soc.  2011 Jul;52(7):838-845. 10.3341/jkos.2011.52.7.838.

Intravitreal Ranibizumab Therapy for Neovascular Age-Related Macular Degeneration with a Predominantly Hemorrhagic Lesion

• Cho YJ
• Park SP

• KMID: 2214709
• DOI: http://doi.org/10.3341/jkos.2011.52.7.838

Abstract

PURPOSE
To report the efficacy and safety of intravitreal ranibizumab monotherapy in patients with age-related macular degeneration with a predominantly hemorrhagic lesion.
METHODS
Nineteen eyes of 19 patients with submacular hemorrhage involving the fovea were treated with intravitreal ranibizumab (0.5 mg/0.05 ml) injections as needed. All patients completed at least 4 months of follow-up. Ophthalmologic examinations, fluorescence angiographic evaluations, optical coherence tomography (OCT) examination, and hemorrhage size were analyzed before the injections, and at 1,2,4,6, and 12 months follow-up.
RESULTS
The average VA and mean central retinal thickness (CRT) before ranibizumab treatment were 0.62 +/- 0.39 log MAR and 335.76 +/- 111.22 microm, respectively. Additionally, the VA and CRT four months after the initial injections were 0.54 +/- 0.43 log MAR and 241.42 +/- 107.55 microm, respectively. The mean size of the hemorrhage was significantly reduced from 2.87 +/- 2.44 DA (disk areas) at baseline to 0.9 +/- 1.28 DA at four month follow up.
CONCLUSIONS
Intravitreal injection of ranibizumab is an effective treatment option for patients with age-related macular degeneration with a predominantly hemorrhagic lesion.

Keyword

Age-related macular degeneration; Predominantly hemorrhagic lesion; Ranibizumab

MeSH Terms

Antibodies, Monoclonal, Humanized
Eye
Fluorescence
Follow-Up Studies
Hemorrhage
Humans
Intravitreal Injections
Macular Degeneration
Retinaldehyde
Tomography, Optical Coherence
Ranibizumab
Antibodies, Monoclonal, Humanized
Retinaldehyde

Figure

• 

  Figure 1. Changes in best corrected visual acuity (BCVA) after intravitreal ranibizumab injection. Best corrected visual acuity improved at 1 month from baseline, a difference that was statistically significant (p < 0.001), this level of BCVA was maintained throughout 2 months. * Not significant differences.

• 

  Figure 2. Changes in central macular thickness with OCT during follow-up after intravitreal ranibizumab injection. The foveal thickness improved after 1 month, the mean central macular thickness measurements decreased from 335.74 ± 111.22 μ m to 271.42 ± 76.9 μ m (p = 0.006) and this overall improvement continued throughout 4 month follow-up.

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  Figure 3. Correlation analysis between the decrease of central macular thickness and the improvement of best-corrected visual acuity (BCVA) four months after initial treatment (Pearson correlation, r = 0.45; p= 0.055).

• 

  Figure 4. The fundus photographs (A, D), fluorescein angiographs (B, C) of patient 18. (A) Baseline fundus photograph showed submacular hemorrhage. (B, C) Early and late phase fluorescein angiography at baseline. Blocked fluorescence is seen around the hyperfluorescence. (D) Fundus photograph at 4 months after treatment showed resolution of hemorrhage.

Reference

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