Intravitreal ranibizumab as primary treatment for neovascular membrane associated with idiopathic juxtafoveal retinal telangiectasia

Objectives: To report the results of intravitreal ranibizumab injection as primary therapy in aggressive posterior retinopathy of prematurity, the process of the disease, and the additive treatments performed. Methods: This retrospective case review included 15 eyes of 8 premature babies with aggressive posterior retinopathy of prematurity who were initially treated with intravitreal ranibizumab injection. The documented data were gestational age, birth weight, gender, postmenstrual age at intravitreal ranibizumab injection, zone of retinopathy of prematurity, reactivation time of disease, iris neovascularization, retinal hemorrhage, anatomical outcome, and additional treatment. Results: Median gestational age at birth was 26 (range, 23–27) weeks, birth weight was 730 (range, 550–970) g, and postconceptional age at aggressive posterior retinopathy of prematurity diagnosis and intravitreal ranibizumab injection was 35 (range, 33–35) weeks. Intravitreal ranibizumab injection was performed as primary treatment. Two eyes necessitated a second intravitreal ranibizumab injection. The reactivation of retinopathy of prematurity was 5 (range, 3–7) weeks after intravitreal ranibizumab injection. Recurrence of the disease in Zone II was treated with laser photocoagulation. A favorable outcome was obtained in all eyes (100%). Conclusion: Aggressive posterior retinopathy of prematurity is a serious, rapidly progressing form of retinopathy of prematurity that requires quick and proper management. This study indicates that primary treatment with ranibizumab and laser photocoagulation on recurrence provide favorable anatomical outcomes.

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Anatomical and functional outcomes following switching from aflibercept to ranibizumab in neovascular age-related macular degeneration in Europe: SAFARI study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-314251 ◽

2019 ◽

Vol 104 (4) ◽

pp. 493-499 ◽

Cited By ~ 3

Author(s):

Richard P Gale ◽

Ian Pearce ◽

Nicole Eter ◽

Faruque Ghanchi ◽

Frank G Holz ◽

...

Keyword(s):

Treatment Failure ◽

Macular Degeneration ◽

Treatment Response ◽

Functional Outcomes ◽

Primary Treatment ◽

Age Related Macular Degeneration ◽

Intravitreal Ranibizumab ◽

Eligibility Criteria ◽

Age Related ◽

The Uk

Background/AimsProspective data on switching anti-vascular endothelial growth factors in patients with neovascular age-related macular degeneration (nAMD) who have previously shown no/partial response are limited. This prospective study assessed the effect of switching from aflibercept to ranibizumab on anatomical and functional outcomes in patients with persistent/recurrent disease activity.MethodsSAFARI (NCT02161575) was a 6-month, prospective, single-arm study conducted in the UK and Germany. Patients, meeting strict eligibility criteria for one of two subgroups (primary treatment failure or suboptimal treatment response), received 3 monthly intravitreal ranibizumab injections (0.5 mg). Thereafter, ranibizumab was administered pro re nata at monthly visits. The primary endpoint was change from baseline (CfB) to day 90 in central subfield retinal thickness (CSRT). Best-corrected visual acuity (BCVA) and retinal morphology parameters were assessed.ResultsOne hundred patients were enrolled (primary treatment failure, 1; suboptimal treatment response, 99). In the overall population, there was a significant CfB in median CSRT of −30.75 µm (95% CI −59.50,–20.50; p<0.0001) to day 90. Improvements were also observed in other quantitative and qualitative optical coherence tomography parameters. In Early Treatment Diabetic Retinopathy Study letters assessed by category, 55% and 59% of patients gained 0–≥15 letters versus baseline at day 90 and day 180, respectively. However, mean improvements in BCVA (CfB) to each time point were small (≤2 letters). No new safety signals were identified.ConclusionSwitching from aflibercept to ranibizumab led to a significant improvement in CSRT, with ~60% experiencing stabilised/improved BCVA. Therefore, patients with nAMD who have shown a suboptimal response to aflibercept may benefit from switching to ranibizumab.

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