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Revista Brasileira de Oftalmologia

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Abstract

AMARO, Miguel Hage et al. Treatment of nonsubfoveal choroidal neovascularization in age-related macular degeneration: analysis of a cases series and revision paper. Rev. bras.oftalmol. [online]. 2011, vol.70, n.4, pp. 261-267. ISSN 0034-7280.  http://dx.doi.org/10.1590/S0034-72802011000400012.

Age-related macular degeneration is a major cause of central vision loss and is the leading cause of blindness for people aged over 60 years. PURPOSE: To investigate the efficacy of intravitreal injection of Ranibizumab (anti-VEGF) in the treatment of choroidal neovascularization nonsubfoveal, extra-foveal or juxta-foveal, caused by age-related macular degeneration and revision paper. METHODS: The study design was descriptive and transverse.15 patients with nonsubfoveal choroidal neovascularization caused by age-related macular degeneration, were treated with intravitreal injection of Ranibzumab per month, at least for three consecutive months. Patients were examined at one month interval between the injections and evaluated using visual acuity testing with Snellen charts, fluorescein angiography, and optical coherence tomography scans. RESULTS: There were 11extra-foveal lesions (73.3%) and 4 juxta-foveal lesions (26.6%). Seven lesions were predominantly classic (46.6%) and eight lesions were occult (53,3%). The mean number of injections performed was 3.67 and the lowest number of injections 3 and 6 larger injections. Eight (53.3%) patients had complete resolution of the exudative neovascular condition with a maximum of three injections and only one (6.67%) patient required six injections to resolution his condition. The best visual acuity achieved was 20/30, and occurred in five (33.3%) patients. The mean visual acuity at diagnosis was 0.44 logMAR and 0.27 logMAR final average. In the final evaluation of patients after six months of study, the average line of sight gains were 1.87 line of visual acuity by Snellen chart. All 15 patients gained one or more lines of vision. CONCLUSION: In the treatment of patients with nonsubfoveal choroidal neovascularization in age-related macular degeneration, injection of Ranibizumab was effective and could be an option as an indication of initial treatment in these cases.

Keywords : Angiogenesis inhibitors [therapeutic use]; Antibodies; monoclonal; Macular degeneration [drug therapy]; Choroidal neovascularization [drug therapy]; Fovea centralis [drug effects].

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