Corinne Gonzalez (Toulouse, France)

Advantages:

Effective, efficient – Good functional results with same or less injections than protocol studies – secure but less restrictive follow-up – less recurrences, – more retinal protective, – lastly cheaper.

Methods:

92 eyes of 81 patients, 25 men, 56 women, with retrofoveolar neovascularisation complicating AMD. 55 were inaugural cases. Patients received intravitreous Ranibizumab, 3 times, every 4 weeks in an inductive treatment. The next injections depended on the follow-up results, and were done by series of 3. First and 2 months’ interval follow-up exam included ETDRS visual acuity (VA), complete ophthalmic examination, fluorescein and infracyanine (ICG) angiography, and optical coherence tomography (OCT). VA and OCT were done before each IVT. We want to evaluate the incidence of this protocol on the frequency of recurrences so on the number of IVT needed.

Effectiveness / Safety:

VA improved in 80% inaugural cases, in 85% already treated. Angiographic leakage reduced about 70% in 75% cases, 30% in 90% cases. At ICG, vascular flow, vessel’s diameter was 2/3 time less in 65% cases, 1/3 in 85% cases. Diffuse edema was 30% reduced in 85%, pigment epithelial detachment was flattened and less dense in all cases, by OCT. Most of patients had good functional, anatomical, vascular flow, results, with less IVT needed. Inductive treatment was sufficient in 45 cases, needed added IVT in 47 cases, failed in 3 cases (combined therapy was done). No bad side effects, no complications.

Take home message:

Effective and less restrictive neovascular AMD treatment protocol.