Resumo

MURIEL, M.A.; FATELA, B.; VALDIVIA, A.  e  CLEMENT, F.. Treatment of wet age-related macular degeneration with ranibizumab in clinical practice: results and prognostic factors. Arch Soc Esp Oftalmol [online]. 2011, vol.86, n.8, pp.254-259. ISSN 0365-6691.

Objectives: To evaluate the efficacy of ranibizumab in wet age-related macular degeneration (ARMD), and to identify prognostic factors. Methods: A retrospective longitudinal study of 79 eyes treated with intravitreal Ranibizumab in our hospital due to wet ARMD, with an initial regimen of three consecutive monthly injections, followed by injections on demand based on the exploratory findings. We conducted a descriptive study of the baseline examination (n=79), and 3 (n=79), 6 (n=67) and 12 months (n=49) after starting treatment. The characteristics of the baseline examination and annual examination results were compared using univariate and multivariate analysis. Results: After the three initial injections, the 93.67% of patients lost fewer than 15 letters, and 19% gained 15 points or more. This result remained similar at 1 year (83.67% and 20.40%, respectively). After 1 year of treatment 40.82% had a VA > 0.3 and 22´45% had a VA < 0.1. We used a median of 5 injections per year. The increased AV at the beginning and the persistence of large intraretinal cysts at 3 months (P=.0013), as well as the development of fibrosis during evolution (P=.0005), are associated with visual deterioration. Conclusions: The guidelines used here stabilised or improved visual acuity in most patients. The most favourable cases are those with initially lower VA or large intraretinal cysts resolved after the loading phase. The appearance of fibrosis implies a poor long-term visual prognosis.

Palavras-chave : Ranibizumab; Age-related macular degeneration; Retinal angiomatous proliferation; Choroidal neovascularisation; Retrospective study.

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