Non-Responders to Intravitreal Ranibizumab in Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular Degeneration

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Abstract

Aim: Evaluation of the proportion of patients affected by subfoveal choroidal neovascularization secondary to age-related macular degeneration who are non-respondent to intravitreal ranibizumab injections (IVRI). Methods: Patients received 3 monthly IVRI, with monthly retreatments, in accordance with a pro re nata scheme (fluid on optical coherence tomography, leakage on fluorescein angiography, new haemorrhages). Non-responders were classified as follows: functional non-responder (best-corrected visual acuity worsening by a minimum of 2 ETDRS lines); anatomical non-responder (central foveal thickness not decreasing by at least 10% compared with baseline value); complete non-responder (both anatomical and functional non-responder criteria apply). Primary outcome measure: identification of the proportion of non-responders. Results: Four patients (7%) were functional non-responders at the 1-month examination, and 5, 5 and 7% at the 2-, 3- and 6-month examinations, respectively. Two of 4 initial non-responders were reclassified as responders during the 6-month follow-up. Twenty-three eyes (43%) were anatomical non-responders at the 1-month visit, and 32, 28 and 21% at 2, 3 and 6 months, respectively. Sixteen of 23 (70%) initially non-respondent eyes became respondent over the follow-up. Two eyes (4%) were classified as complete non-responders after 1 month. Non-responders amounted to 4, 0 and 2% at the 2-, 3- and 6-month examinations, respectively. No initially complete non-responding eye remained so over the follow-up. Conclusion: Data indicate a low proportion of functional and anatomical non-responders to IVRI. Further studies are warranted providing a better definition of non-responder and a clearer picture of the magnitude of response, when present. © 2016 S. Karger AG, Basel
Original languageEnglish
Pages (from-to)42-47
Number of pages6
JournalOphthalmic Research
Volume57
Issue number1
DOIs
Publication statusPublished - 2017

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Choroidal Neovascularization
Macular Degeneration
Intravitreal Injections
Retreatment
Fluorescein Angiography
Optical Coherence Tomography
Visual Acuity
Outcome Assessment (Health Care)
Hemorrhage
Ranibizumab

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@article{a1f461764fd248cfa2d08dff29577d85,
title = "Non-Responders to Intravitreal Ranibizumab in Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular Degeneration",
abstract = "Aim: Evaluation of the proportion of patients affected by subfoveal choroidal neovascularization secondary to age-related macular degeneration who are non-respondent to intravitreal ranibizumab injections (IVRI). Methods: Patients received 3 monthly IVRI, with monthly retreatments, in accordance with a pro re nata scheme (fluid on optical coherence tomography, leakage on fluorescein angiography, new haemorrhages). Non-responders were classified as follows: functional non-responder (best-corrected visual acuity worsening by a minimum of 2 ETDRS lines); anatomical non-responder (central foveal thickness not decreasing by at least 10{\%} compared with baseline value); complete non-responder (both anatomical and functional non-responder criteria apply). Primary outcome measure: identification of the proportion of non-responders. Results: Four patients (7{\%}) were functional non-responders at the 1-month examination, and 5, 5 and 7{\%} at the 2-, 3- and 6-month examinations, respectively. Two of 4 initial non-responders were reclassified as responders during the 6-month follow-up. Twenty-three eyes (43{\%}) were anatomical non-responders at the 1-month visit, and 32, 28 and 21{\%} at 2, 3 and 6 months, respectively. Sixteen of 23 (70{\%}) initially non-respondent eyes became respondent over the follow-up. Two eyes (4{\%}) were classified as complete non-responders after 1 month. Non-responders amounted to 4, 0 and 2{\%} at the 2-, 3- and 6-month examinations, respectively. No initially complete non-responding eye remained so over the follow-up. Conclusion: Data indicate a low proportion of functional and anatomical non-responders to IVRI. Further studies are warranted providing a better definition of non-responder and a clearer picture of the magnitude of response, when present. {\circledC} 2016 S. Karger AG, Basel",
author = "P Iacono and {Battaglia Parodi}, M and F Bandello",
year = "2017",
doi = "10.1159/000448955",
language = "English",
volume = "57",
pages = "42--47",
journal = "Ophthalmic Research",
issn = "0030-3747",
publisher = "S. Karger AG",
number = "1",

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TY - JOUR

T1 - Non-Responders to Intravitreal Ranibizumab in Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular Degeneration

AU - Iacono, P

AU - Battaglia Parodi, M

AU - Bandello, F

PY - 2017

Y1 - 2017

N2 - Aim: Evaluation of the proportion of patients affected by subfoveal choroidal neovascularization secondary to age-related macular degeneration who are non-respondent to intravitreal ranibizumab injections (IVRI). Methods: Patients received 3 monthly IVRI, with monthly retreatments, in accordance with a pro re nata scheme (fluid on optical coherence tomography, leakage on fluorescein angiography, new haemorrhages). Non-responders were classified as follows: functional non-responder (best-corrected visual acuity worsening by a minimum of 2 ETDRS lines); anatomical non-responder (central foveal thickness not decreasing by at least 10% compared with baseline value); complete non-responder (both anatomical and functional non-responder criteria apply). Primary outcome measure: identification of the proportion of non-responders. Results: Four patients (7%) were functional non-responders at the 1-month examination, and 5, 5 and 7% at the 2-, 3- and 6-month examinations, respectively. Two of 4 initial non-responders were reclassified as responders during the 6-month follow-up. Twenty-three eyes (43%) were anatomical non-responders at the 1-month visit, and 32, 28 and 21% at 2, 3 and 6 months, respectively. Sixteen of 23 (70%) initially non-respondent eyes became respondent over the follow-up. Two eyes (4%) were classified as complete non-responders after 1 month. Non-responders amounted to 4, 0 and 2% at the 2-, 3- and 6-month examinations, respectively. No initially complete non-responding eye remained so over the follow-up. Conclusion: Data indicate a low proportion of functional and anatomical non-responders to IVRI. Further studies are warranted providing a better definition of non-responder and a clearer picture of the magnitude of response, when present. © 2016 S. Karger AG, Basel

AB - Aim: Evaluation of the proportion of patients affected by subfoveal choroidal neovascularization secondary to age-related macular degeneration who are non-respondent to intravitreal ranibizumab injections (IVRI). Methods: Patients received 3 monthly IVRI, with monthly retreatments, in accordance with a pro re nata scheme (fluid on optical coherence tomography, leakage on fluorescein angiography, new haemorrhages). Non-responders were classified as follows: functional non-responder (best-corrected visual acuity worsening by a minimum of 2 ETDRS lines); anatomical non-responder (central foveal thickness not decreasing by at least 10% compared with baseline value); complete non-responder (both anatomical and functional non-responder criteria apply). Primary outcome measure: identification of the proportion of non-responders. Results: Four patients (7%) were functional non-responders at the 1-month examination, and 5, 5 and 7% at the 2-, 3- and 6-month examinations, respectively. Two of 4 initial non-responders were reclassified as responders during the 6-month follow-up. Twenty-three eyes (43%) were anatomical non-responders at the 1-month visit, and 32, 28 and 21% at 2, 3 and 6 months, respectively. Sixteen of 23 (70%) initially non-respondent eyes became respondent over the follow-up. Two eyes (4%) were classified as complete non-responders after 1 month. Non-responders amounted to 4, 0 and 2% at the 2-, 3- and 6-month examinations, respectively. No initially complete non-responding eye remained so over the follow-up. Conclusion: Data indicate a low proportion of functional and anatomical non-responders to IVRI. Further studies are warranted providing a better definition of non-responder and a clearer picture of the magnitude of response, when present. © 2016 S. Karger AG, Basel

U2 - 10.1159/000448955

DO - 10.1159/000448955

M3 - Article

VL - 57

SP - 42

EP - 47

JO - Ophthalmic Research

JF - Ophthalmic Research

SN - 0030-3747

IS - 1

ER -