Predictive factors for non-response to intravitreal ranibizumab treatment in age-related macular degeneration
Open Access
- 7 April 2014
- journal article
- research article
- Published by BMJ in British Journal of Ophthalmology
- Vol. 98 (9), 1186-1191
- https://doi.org/10.1136/bjophthalmol-2013-304670
Abstract
Background/aims To study the initial characteristics and response to intravitreal ranibizumab (IVR) treatment of age-related macular degeneration (AMD). Methods We reviewed the clinical records of 141 eyes in 141 AMD patients who received monthly IVR for 3 months and thereafter pro re nata (PRN) injections for 9 months as the first treatment for AMD. Patients whose best corrected visual acuity (BCVA) worsened at month 12, and those with increased exudative fundus findings after IVR or an increased central retinal thickness of more than 100 μm at month 12, were considered to be non-responders as judged by BCVA and fundus findings, respectively. Non-responders’ initial characteristics were analysed using logistic regression models. Results 14.9% of eyes were non-responders as judged by BCVA, and 17.0% were non-responders as judged by fundus findings. Initial fibrovascular pigment epithelial detachment (PED) (OR 22.9, 95% CI 2.61 to 201) and serous PED (OR 4.12, 95% CI 1.08 to 15.8) were associated with non-response as judged by BCVA. Initial fibrovascular PED (OR 33.5, 95% CI 2.95 to 381) and type 1 choroidal neovascularization (OR 6.46, 95% CI 1.39 to 30.0) were associated with non-response, as judged by fundus findings. Conclusions Although most AMD responded to IVR, non-responders had initial clinical characteristics that might be informative for managing their treatment.Keywords
This publication has 18 references indexed in Scilit:
- Four-Year Treatment Results of Neovascular Age-Related Macular Degeneration With Ranibizumab and Causes for Discontinuation of TreatmentAmerican Journal of Ophthalmology, 2012
- Ranibizumab versus Bevacizumab to Treat Neovascular Age-related Macular Degeneration: One-Year Findings from the IVAN Randomized TrialOphthalmology, 2012
- Ranibizumab and Bevacizumab for Neovascular Age-Related Macular DegenerationNew England Journal of Medicine, 2011
- INTRAVITREAL BEVACIZUMAB AS PRIMARY TREATMENT FOR RETINAL ANGIOMATOUS PROLIFERATIONRetina, 2009
- Non-responders to bevacizumab (Avastin) therapy of choroidal neovascular lesionsBritish Journal of Ophthalmology, 2007
- Fibrosis and diseases of the eyeJCI Insight, 2007
- Ranibizumab versus Verteporfin for Neovascular Age-Related Macular DegenerationNew England Journal of Medicine, 2006
- Ranibizumab for Neovascular Age-Related Macular DegenerationNew England Journal of Medicine, 2006
- Pegaptanib for Neovascular Age-Related Macular DegenerationNew England Journal of Medicine, 2004
- Control of subretinal fluid: Experimental and clinical studiesEye, 1990