Outcome following ranibizimab therapy for neovascular age related macular degeneration in patients with poor, intermediate and good vision

Purpose To assess the visual outcome following intravitreal ranibizumab in eyes with wet age related macular degeneration(AMD) in patients with three different baseline vision viz; <35, 35‐54 and >54 ETDRS letters. Methods This study assessed the ETDRS visual acuity at diferent time points in a total of 98 patients.Optical coherent tomography and fundus fluorescein angiography FFA was carried out at baseline and thereafter when required. Intravitreal ranibizumab was administered monthly for 3 months and when necessary as guided by vision and OCT. Follow up period was 6 months. Results In the 27 patients with baseline vision < 35 letters, the mean change in vision at 6 months from baseline is +8 (p=0.04). None of the patients lost more than 15 letters (floor effect) and 35% gained more than 15 letters. In 43 patients with baseline vision 35‐54 letters the mean change in vision at 6 months is +10 letters(p=0.0003). None of the patients lost more than 15 letters or gained more than 15 letters.Twenty‐eight patients baseline vision > 54 letters had a mean change in vision at 6 months of +6 (p=0.4). Only 16% gained more than 15 letters(ceiling effect). All the three groups were observed to have improvement of vision in the 3rd month which was sustained in the 6 month.Patients with baseline vision more than 54 letters receive an average of 3.52 injections over the 6 month period. Those with vision 35‐54 and <35 received an average of 3.42 and 3.56 injections respectively over the same period. Conclusion Response to ranibizumab in patients with good and intermediate and poor vision at baseline was similar to the ANCHOR and MARINA studies up to 6 months.