Article
Vascular endothelial growth factor (VEGF) levels in patients with exudative age-related macular degeneration treated with ranibizumab
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Published: | May 30, 2012 |
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Background: To analyze the temporal correlations of vascular endothelial growth factor (VEGF) suppression, morphologic/functional recurrence of choroidal neovascularization (CNV) in eyes with exudative age-related macular degeneration (AMD) treated with ranibizumab.
Methods: In this non-randomized prospective clinical study, aqueous humor specimens from 47 patients with exudative AMD were taken before each intravitreal ranibizumab injection. Visual acuity testing and spectral domain optical coherence tomography (SD-OCT) were performed prior to each injection. VEGF-A was measured by Luminex multiplex bead analysis.
Results: Ranibizumab resulted in complete VEGF suppression within a mean period of 37.8 days (SD ± 4.8). Recurrences of CNV activity as determined by SD-OCT occurred 93.7 days (SD ± 69.9) after the last ranibizumab treatment (p<0.0001). VEGF levels were never suppressed when a recurrence occurred. Functional recurrence (visual acuity) occurred 114.3 days (SD ± 81.4, p=0.026) after previous treatment.
Conclusions: An intravitreal dosing of 0.5 mg ranibizumab results in a permanent VEGF inhibition if injected every four weeks. CNV recurrences as determined by SD-OCT are always preceded by a loss of intraocular VEGF suppression, and are usually followed by loss of visual acuity in the further course.