Initial non-responders to ranibizumab in the treatment of age-related macular degeneration (AMD)

Tsuyoshi Otsuji,1 Yoshimi Nagai,2 Kenichiro Sho,1 Akiko Tsumura,1 Naoko Koike,1 Mei Tsuda,1 Tetsuya Nishimura,1 Kanji Takahashi2 1Department of Ophthalmology, Kansai Medical University, Takii Hospital, Osaka, Japan; 2Department of Ophthalmology, Kansai Medical University, Hirakata Hospital, Osaka, J...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Otsuji T, Nagai Y, Sho K, Tsumura A, Koike N, Tsuda M, Nishimura T, Takahashi K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/39faaa2deaa44e92a4d7a740e4fe989e
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:39faaa2deaa44e92a4d7a740e4fe989e
record_format	dspace
spelling	oai:doaj.org-article:39faaa2deaa44e92a4d7a740e4fe989e2021-12-02T07:45:42ZInitial non-responders to ranibizumab in the treatment of age-related macular degeneration (AMD)1177-54671177-5483https://doaj.org/article/39faaa2deaa44e92a4d7a740e4fe989e2013-07-01T00:00:00Zhttp://www.dovepress.com/initial-non-responders-to-ranibizumab-in-the-treatment-of-age-related--a13720https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Tsuyoshi Otsuji,1 Yoshimi Nagai,2 Kenichiro Sho,1 Akiko Tsumura,1 Naoko Koike,1 Mei Tsuda,1 Tetsuya Nishimura,1 Kanji Takahashi2 1Department of Ophthalmology, Kansai Medical University, Takii Hospital, Osaka, Japan; 2Department of Ophthalmology, Kansai Medical University, Hirakata Hospital, Osaka, Japan Background: Patients with exudative age-related macular degeneration (AMD) who did not respond to ranibizumab at the induction phase were assessed and referred to as initial non-responders. Methods: We retrospectively reviewed the medical records of 215 patients (218 eyes) with exudative AMD. For the initial treatments, patients received three intravitreal injections of ranibizumab (IVR) every 4 weeks. Minimum follow-up period was 12 months. We defined patients with no improvement of best corrected logMAR visual acuity (BCVA), and with no decrease of central retinal thickness (CRT) at the end of the initial treatment, as initial non-responders. Patients who had previous treatment history prior to this investigation were included, but patients who had photodynamic therapy (PDT) with IVR were excluded. Results: Twenty-two eyes (10.1%) were identified as initial non-responders. The mean BCVA of initial non-responders before IVR and after induction phase were 0.39 and 0.36, respectively. There was no significant difference between these values, however the mean BCVA decreased significantly to 0.55 at 12 months after the beginning of the induction phase (P = 0.021). The mean greatest linear dimension (GLD) of the lesion before IVR of initial non-responders was 4,121 µm. We found 16 eyes with typical AMD, and six eyes with polypoidal choroidal vasculopathy. One eye had predominantly classic choroidal neovascularization (CNV), and others had occult CNV of typical AMD. As additional treatments, twelve eyes received PDT, and in three of the eyes exudation remained after PDT. Conclusion: Initial non-responders were more prevalent in patients with occult CNV than in patients with other CNV types. Some of the initial non-responders did not respond to PDT. This study suggested possible involvement of other factors, in addition to vascular endothelial growth factor, in the occurrence of CNV in initial non-responder patients. Keywords: AMD, anti-VEGF drug, ranibizumab, initial non-respondersOtsuji TNagai YSho KTsumura AKoike NTsuda MNishimura TTakahashi KDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 1487-1490 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Otsuji T Nagai Y Sho K Tsumura A Koike N Tsuda M Nishimura T Takahashi K Initial non-responders to ranibizumab in the treatment of age-related macular degeneration (AMD)
description	Tsuyoshi Otsuji,1 Yoshimi Nagai,2 Kenichiro Sho,1 Akiko Tsumura,1 Naoko Koike,1 Mei Tsuda,1 Tetsuya Nishimura,1 Kanji Takahashi2 1Department of Ophthalmology, Kansai Medical University, Takii Hospital, Osaka, Japan; 2Department of Ophthalmology, Kansai Medical University, Hirakata Hospital, Osaka, Japan Background: Patients with exudative age-related macular degeneration (AMD) who did not respond to ranibizumab at the induction phase were assessed and referred to as initial non-responders. Methods: We retrospectively reviewed the medical records of 215 patients (218 eyes) with exudative AMD. For the initial treatments, patients received three intravitreal injections of ranibizumab (IVR) every 4 weeks. Minimum follow-up period was 12 months. We defined patients with no improvement of best corrected logMAR visual acuity (BCVA), and with no decrease of central retinal thickness (CRT) at the end of the initial treatment, as initial non-responders. Patients who had previous treatment history prior to this investigation were included, but patients who had photodynamic therapy (PDT) with IVR were excluded. Results: Twenty-two eyes (10.1%) were identified as initial non-responders. The mean BCVA of initial non-responders before IVR and after induction phase were 0.39 and 0.36, respectively. There was no significant difference between these values, however the mean BCVA decreased significantly to 0.55 at 12 months after the beginning of the induction phase (P = 0.021). The mean greatest linear dimension (GLD) of the lesion before IVR of initial non-responders was 4,121 µm. We found 16 eyes with typical AMD, and six eyes with polypoidal choroidal vasculopathy. One eye had predominantly classic choroidal neovascularization (CNV), and others had occult CNV of typical AMD. As additional treatments, twelve eyes received PDT, and in three of the eyes exudation remained after PDT. Conclusion: Initial non-responders were more prevalent in patients with occult CNV than in patients with other CNV types. Some of the initial non-responders did not respond to PDT. This study suggested possible involvement of other factors, in addition to vascular endothelial growth factor, in the occurrence of CNV in initial non-responder patients. Keywords: AMD, anti-VEGF drug, ranibizumab, initial non-responders
format	article
author	Otsuji T Nagai Y Sho K Tsumura A Koike N Tsuda M Nishimura T Takahashi K
author_facet	Otsuji T Nagai Y Sho K Tsumura A Koike N Tsuda M Nishimura T Takahashi K
author_sort	Otsuji T
title	Initial non-responders to ranibizumab in the treatment of age-related macular degeneration (AMD)
title_short	Initial non-responders to ranibizumab in the treatment of age-related macular degeneration (AMD)
title_full	Initial non-responders to ranibizumab in the treatment of age-related macular degeneration (AMD)
title_fullStr	Initial non-responders to ranibizumab in the treatment of age-related macular degeneration (AMD)
title_full_unstemmed	Initial non-responders to ranibizumab in the treatment of age-related macular degeneration (AMD)
title_sort	initial non-responders to ranibizumab in the treatment of age-related macular degeneration (amd)
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/39faaa2deaa44e92a4d7a740e4fe989e
work_keys_str_mv	AT otsujit initialnonresponderstoranibizumabinthetreatmentofagerelatedmaculardegenerationamd AT nagaiy initialnonresponderstoranibizumabinthetreatmentofagerelatedmaculardegenerationamd AT shok initialnonresponderstoranibizumabinthetreatmentofagerelatedmaculardegenerationamd AT tsumuraa initialnonresponderstoranibizumabinthetreatmentofagerelatedmaculardegenerationamd AT koiken initialnonresponderstoranibizumabinthetreatmentofagerelatedmaculardegenerationamd AT tsudam initialnonresponderstoranibizumabinthetreatmentofagerelatedmaculardegenerationamd AT nishimurat initialnonresponderstoranibizumabinthetreatmentofagerelatedmaculardegenerationamd AT takahashik initialnonresponderstoranibizumabinthetreatmentofagerelatedmaculardegenerationamd
_version_	1718399214838349824

Initial non-responders to ranibizumab in the treatment of age-related macular degeneration (AMD)

Ejemplares similares