A prospective, randomized, parallel group, double blind, multicenter study to compare the efficacy, safety and immunogenicity of Lupin’s Ranibizumab with Lucentis® in patients with neovascular age-related macular degeneration

Purpose: The present study compares the efficacy, safety, and immunogenicity of Lupin’s biosimilar ranibizumab with that of Lucentis® in patients with neovascular age-related macular degeneration. Methods: This prospective, double-blind, multi-centric phase-III study was conducted across 19 centers in India. A total of 202 patients with neovascular age-related macular degeneration were randomized (1:1) to receive either Lupin’s biosimilar ranibizumab or Lucentis®, 0.5 mg, as an intravitreous injection once every month for 3 months. The primary efficacy endpoint was the proportion of patients who lost fewer than 15 letters from baseline in best-corrected visual acuity. The safety profile included assessment of adverse events, ophthalmic examination, physical and systemic examination, and vital parameters. The immunogenicity assessment was based on evaluation of anti-drug antibodies. Results: Overall, 174 patients (87 [86.14%] in each group) completed the study. The demographics and baseline characteristics were comparable between the treatment groups. The proportion of patients losing fewer than 15 letters from baseline best corrected visual acuity score in the study eye was comparable between two groups. The difference between Lupin’s ranibizumab and Lucentis® for the proportion of patients who lost fewer than 15 letters was within the predefined equivalence margin (intention-to-treat population: 1.0%; 95% confidence interval [CI], ?3.3% to 5.4% and per protocol population: 1.2%; 95% CI, ?3.2% to 6.4%). The incidence of treatment-emergent adverse events was comparable, and 11 (10.89%) patients in Lupin’s ranibizumab and 19 (18.81%) patients in Lucentis® group had at least one treatment-emergent adverse event. The immunogenicity incidence as assessed by proportion of patients with positive anti-drug antibodies was numerically lower in Lupin’s ranibizumab (4.95%) than Lucentis® (12.87%). Conclusion: Lupin’s biosimilar ranibizumab demonstrated therapeutic equivalence, desirable safety, and favorable immunogenicity profile compared to Lucentis

Effect analysis of the intravitreal Conbercept in the treatment of choroid neovascularization of macular with high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the effect of intravitreal conbercept in the treatment of chorionic neovascularization(CNV)of macular macula with high myopia. <p>METHODS: Totally 56 patients with high myopia caused by macular angiogenesis in our hospital were retrospectively selected as the research objects from June 2015 to December 2019. According to the treatment methods, patients were divided into the control group and the observation group. The 28 cases(28 eyes)of patients in the control group were treated with the intravitreous injection of Rayzumab, and 28 cases(28 eyes)of patients in the observation group were treated with intravitreal injection of conbercept. After the last treatment, the patients were followed up for 3mo to record the intraocular pressure, the best corrected visual acuity(BCVA)and the incidence of complications. Optical coherence tomography(OCT)was used to measure the thickness of macular fovea retinal(CMT), and horizontal linear scanning of OCT instrument was used to measure the CNV area.<p>RESULTS:After treatment, the visual acuity of patients in the observation group gradually increased, and the improvement of BCVA was significantly higher than that of the control group at the same time point(<i>P</i><0.05). After 3mo of treatment, it showed that IOP, CNV area and CMT in the observation group were significantly reduced after the combined treatment, and the improvement was better than that in the control group(<i>P</i><0.05). The incidence of complications in the observation group(4%)was significantly lower than that in the control group(18%).<p>CONCLUSION:The treatment of intravitreal conbercept injection for the high myopia CNV was superior to lucentis, which could improve clinical efficacy by increasing BCVA, reducing CMT thickness, improving vision and reducing postoperative complications.

Intravitreal injection of Lucentis combined with trabeculectomy and pan retinal photocoagulation for neovascular glaucoma / 实用医学杂志

Objective To investigate the clinical efficacy of intravitreal injection of Lucentis combined with pan retinal photocoagulation and trabeculectomy for neovascular glaucoma(NVG). Methods Seventeen eyes of 15 patients with NVG were treated by 0.5 mg Lucentis intravitreal injection first. Trabeculectomy was performed 7 days later and Pan retinal photocoagulation 2 weeks later. Iris,anterior chamber angle neovascularization,intraocu?lar pressure ,and visual acuity were observed in the following 6 months. Results Iris and anterior chamber angle neovascularization were completely regressed 7 days after the injection in 17 eyes. Six months after photocoagulation, 6 eyes had different degrees of improvement in visual acuity,10 eyes no change in visual acuity and 1 eye decreased from anterior index to immediate manual. There was significant difference in pre?treatment IOP and postoperative IOP( t = 12.75 ,10.26 ,9.73 ,10.77 ,P < 0.01 ). No serious complications were observed after intravitreal injec?tion and trabeculectomy. Conclusions Intravitreal injection of Lucentis could significantly accelerate the regres?sion of iris and anterior chamber angle neovascularization ,which could improve the successful rate of trabeculecto?my and pan retinal photocoagulation. Intravitreal injection of Lucentis combined with trabeculectomy and panretinal photocoagulation is safe and effective for NVG.

Intravitreal lucentis injections combined with laser photocoagulation for Coats disease / 眼科新进展

Objective To observe the therapeutic effect of intravitreal lucentis injections combined with laser photocoagulation for Coats disease.Methods This was a retrospective case series study.From August 2012 to December 2015,18 cases (18 eyes) were diagnosed as Coats disease with macular edema by FFA and OCT.All patients were treated at baseline using intravitreal lucentis injections.One week later,photocoagulation was performed by the guiding of FFA.Follow-up treatment was performed as necessary.The primary BCVA and central macular thickness (CMT) was measured postoperatively.The follow-up time was 16-24 months (mean 18.8 months).Results The mean number of lucentis injections was 2.6,and the mean number of laser treatment sessions was 1.8.The mean preoperative BCVA was (0.81 ±0.28) LogMAR,while the final visit was (0.76 ± 0.37) LogMAR (P =0.396).In 3 patients (16.7 ％),BCVA had improved by more than 3 lines,and 13 patients (72.2％)showed stable BCVA (changes within 2 lines of visual acuity),while in 2 patients,BCVA decreased by more than 3 lines (11.1％).The mean CMT improved significantly from (341.11 ±67.97) μm preoperatively to (277.83 ±51.59) μm at the fmal visit (P =0.030).Final BCVA was significantly correlated with preoperative BCVA (r =0.817,P ＜0.001).The final BCVA of patients with subfoveal hard exudates preoperatively was significantly worse than that of patients without such exudates (P =0.044).Conclusion Intravitreal lucentis injection combined with laser photocoagulation may be an effective treatment for Coats disease.It may stablize the visual acuity,decrease the CMT of Coats disease.The final BCVA is associated with preoperative BCVA and occurrence of subfoveal hard exudates.

Clinical efficacy and safety of Kangbusipu combined with leazu monoclonal antibody in the treatment of diabetic macular degeneration / 中国生化药物杂志

Objective To investigate the clinical efficacy and safety of conbercept and lucentis in the treatment of age-related macular degeneration.Methods A total of 66 patients with age-related macular degeneration from our hospital were chosen,the patients or family members signed an agreement,were randomly divided into experiment group and control group with 33 cases in each group.Patients in the control group were treated by lucentis injection therapy; patients in the experiment group were treated by conbercept injection,determined serological indexes and ophthalmic indexes before and after treatment,and the clinical efficacy wascompared,the patients were followed up,the adverse reactions were recorded.Results After treatment,the vision restoration effective rate of the control group 48％was lower than the experiment group 80％,with statistical significance(P<0.05); the adverse reactions rate of the experiment group(20％)compared with the control group(16％),was no difference.Conclusion Conbercept injection in the treatment of age-related macular degeneration can decrease peripheral blood VEGF and CRP contents,reduce the CMT and CNV levels,reduce intraocular pressure,improve vision.

Efficacy of intravitreal lucentis or conbercept injection combined with ahmed glaucoma valve implantation for treatment of neovascular glaucoma / 吉林大学学报(医学版)

Objective:To evaluate the efficacy of intravitreal lucentis or conbercept injection combined with ahmed glaucoma valve (AGV)implantation on the treatment of neovascular glaucoma (NVG).Methods:A total of 68 NVG patients (68 eyes)were divided into three groups according to the pretreatment (the intravitreal injection of lucentis or conbercept or no intravitreal injection 3 - 7 d before AGV implantation):lucentis group (n = 26, given intravitreal injection of 10 g · L-1 lucentis),conbercept group (n = 21, given intravitreal injection of 10 g·L-1 conbercept)and control group (n=21,given medicine or puncture of anterior chamber to smoothen the IOP and received AGV implantation).The panretina photocoagnlation (PRP)was performed in the patients with clear ocular media before intravitreal injection or AGV implantation.For the patients with cloudy ocular media,the intravitreal injection of anti-VEGF drugs was performed first and the PRP was performed when fundus could be seen.Results:Compared with before operation,the mean IOP and the number of antiglaucoma medications of the patients used in three groups after operation were significantly decreased (P < 0.01).There were no significant differences in the successful rates of operation of the patients in three groups at different time points after operation (P >0.05).1 month and 3 months after operation,the BCVA of the patients in lucentis and conbercept groups was significantly better than that in control group (P <0.05).There were no significant differences in the incidence of complications of the pateints between lucentis and conbercept groups at different time points after operation (P >0.05).Conclusion:Intravitreal injection of anti-VEGF drugs combined with AGV implantation is effective and safe in the treatment of NVG.In short term,it can improve the vision,relieve the pain and reduce the complications.

Clinical observation of combined treatment for neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To observe the effect of combined treatment(using intraocular pressure-lowering drugs + intravitreal injection of Lucentis + complex trabeculectomy + panretinal photocoagulation)for neovascular glaucoma(NVG).<p>METHODS: This was a prospective non-randomized clinical study. A total of 24 patients(24 eyes)with NVG were enrolled. After using intraocular pressure(IOP)-lowering drugs, the elevated IOP in 7 eyes was controlled within normal limits and 17 eyes within high levels. All patients were treated with intravitreal injection of Lucentis 0.50mg/0.05mL. Complex trabeculectomy were performed within 7d after injection. All patients were treated with panretinal photocoagulation after complex trabeculectomy. The regression of iris neovascularization, changes in IOP, best corrected visual acuity, intraoperative and postoperative complications and filtering bleb were analyzed after combined treatment. Patients were followed-up for 6-18mo. <p>RESULTS: Iris neovascularization completely regressed within 1wk in 24 eyes after intravitreal injection of Lucentis. The average IOP was 41.38±3.16mmHg before combined treatment,and 12.69±1.52mmHg in 6mo after combined treatment. The differences had statistically significant before and after combined treatment(<i>F</i>=25.592, <i>P</i><0.05). Before combined treatment, the best-corrected visual acuity was >0.1 in 3 eyes, 0.01-0.1 in 10 eyes, non light perception(NLP)- finger counting(FC)in 11 eyes. After combined treatment, the best-corrected visual acuity was >0.1 in 5 eyes, 0.01-0.1 in 16 eyes, NLP～FC in 3 eyes, which showed statistically significant difference with the visual acuity before combined treatment(<i>Z</i>=-2.201, <i>P</i><0.05). <p>CONCLUSION: Combined treatment could effectively control the IOP and preserve the visual function in patients with neovascular glaucoma.

Lucentis preventing vitreous hemorrhage after vitrectomy for diabetic retinopathy combined with iris neovascularization / 眼科新进展

Objective To study the effects of lucentis preventing vitreous hemorrhage after vitrectomy for diabetic retinopathy combined with iris neovascularization.Methods The clinical data of 70 patients (70 eyes) underwent vitrectomy for diabetic retinopathy combined with iris neovascularization during 2009 to 2015 in our hospital were retrospectively analyzed.The control group (30 eyes) accepted panretinal photocoagulation (PRP),re-vitrectomy,cyclocryotherapy,and the study group (40 eyes) had the 0.5mg lucentis in addition.The follow-up time was 3 months,and the visual acuity,IOP,vitreous hemorrhage,INV regression and complication were observed.Results At 1 month,2 months in the follow-up,the visual acuity of study group was better than the control group,but there was no significant difference along with the follow up.The average preoperative IOP was (26.312 ±4.566) mmHg (1 kPa =7.5 mmHg) in the study group and (24.586 ±5.783) mmHg in the control group,and at the end of the follow up,IOP was (18.576 ±4.762) mmHg in the study group and (28.587 ±7.786) mmHg in the control group,there was statistical difference between the two groups (P =0.041).The intraoperative and postoperative anterior chamber or vitreous hemorrhage occurred in 15 cases,5 cases of the control group,and 3 cases,1 case of the control group,there were significant differences (all P =0.000).At the end of the follow up,3 eyes (7.5％) developed to NVG in the study group and 10 eyes (33.3％) in the control group,there was statistical difference (P ＜ 0.05).Conclusion Lucentis can effectively eliminate the new vessels,reduce the incidence of neovascularization glaucoma and vitreous hemorrhage for patients after vitrectomy for diabetic retinopathy combined with iris neovascularization,and improve the visual acuity in a short time.

Effects of intravitreal injection of Lucentis for anterior segment neovascularization indeced by central retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM:To investigate the therapeutic effect of Lucentis in the treatment of anterior segment neovascularization ( ASNV ) induced by central retinal vein occlusion ( CRVO) .?METHODS: This was a retrospective case series study for patients with ASNV secondary to CRVO from January 2013 to December 2014 and treated with intravitreal injection of lucentis. Best visual acuity ( BCVA ) , intraocular pressure ( IOP ) , iris examination and gonioscopy, and if necessary, fluorescein angiography and optical coherence tomography, were recorded.The follow-up time was 6-13mo, the average was 9.1 ± 2.9mo.?RESULTS: Eighteen patients ( 18 eyes ) were treated with intravitreal injection of lucentis;15 patients (15 eyes) of the 18 were treated with panretinal photocoagulation;the other 3 patients 3 eyes were not received the photocoagulation because of vitreous opacity. One patient was treated with glaucoma valve implantation.Six patients with only neovascularization and without glaucoma were improved in visual acuity whose intraocular pressure was controlled after combined treatment.Of the patients with neovascular glaucoma ( n=12 ) , after intravitreal injection of lucentis and panretinal photocoagulation, the IOP was controlled in 4 patients (4 eyes);the IOP of another 7 cases reduced but glaucoma drugs were still needed.One patient ( 1 eye ) received glaucoma valve implantation because of bad control on IOP with worse vision after implantation.The rubeosis disappeared in all patients.?CONCLUSION:Intravitreal injection of lucentis can stop neovascularization and help to control IOP.In the early stage without neovascular glaucoma, lucentis has better effects, which means early detection and intervention are important.

Clinical observation of comprehensive treatment for neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM: To observe the clinical efficacy of intravitreal Lucentis injection combined with panretinal photocoagulation ( PPR ) and compound trabeculectomy for neovascular glaucoma ( NVG) .?METHODS:A total of 14 cases (14 eyes) with NVG were collected from January to November 2015.All cases were treated with intravitreal lucentis injection, PPR and compound trabeculectomy by turns.Intraocular pressure ( IOP) , visual acuity and the complications at pre-or post-surgery were recorded, respectively.?RESULTS: Followed up for 3-6mo, the average IOP preoperatively was significantly decreased than that detected at post-operation ( 18.00 ±6.70 vs 41.65 ± 4.07mmHg, t=11.288, P<0.05).IOP less than 21mmHg with or without the usage of anti-intraocular pressure drugs was defined as the sign of successful or effective surgery, respectively.At the ultimate follow-up, 11 cases were successful, 2 cases were effective, and the success rate was 79%, effective rate was 14%.Only 1 case was applied cyclocryotherapy due to the uncontrolled IOP. Moreover, the results of visual acuity detection demonstrated that 6 eyes got a better visual acuity, 7 eyes remained the same condition and 1 case got no light perception. Meanwhile, 13 cases showed none iris neovascularization during the follow-up; 1 case got a reappearance of iris neovascularization on the third month, which was then dissolved subjected to the intravitreal lucentis injection in combination with PPR. One case developed post -operative hyphema and absorbed after 1wk. No shallow anterior chamber and eyeball atrophy happened.?CONCLUSION:Intravitreal lucentis injection combined with PPR and compound trabeculectomy is an effective and safe therapeutic strategy for the treatment of NVG.

Exploring laser and lucentis treatment of diabetic retinopathy / 中国医学装备

Objective: To analysis the effects of laser and lucentis treatment of diabetic retinopathy. Methods:Fifty-three patients with DR were treated with laser and lucentis in our hospital from October 2012 to October 2013 as observer group. Forty-nine patients with DR were treated with laser in our hospital from September 2011 to September 2012 as control group. Results:The results indicated that visual acuity improved rate was 67.9%and decreased vision rate was 13.2% in observer group. Vision conditions in the observation group was better than that in the control group with significant difference (x2=4.60, x2=3.87; P<0.05). Simultaneously, improve time of hemorrhage, exudates, edema and macular thickness in the observation group was better than that in the control group with significant difference (t=4.17, t=3.92, t=4.06; P<0.05). Conclusion: The laser and lucentis treatment of diabetic retinopathy can significantly improving symptoms of retinal and promoting visual recovery.

Clinical observation of photodynamic therapy combined with vitreous cavity injection of Lucentis treatment for choroidal neovascularization diseases / 重庆医学

Objective To investigate the efficacy and safety of photodynamic therapy(PDT) combined with vitreous cavity injec‐tion of Lucentis treatment for choroidal neovascularization(CNV) diseases .Methods we retrospectively analyzed data of 30 cases (30 eyes) of CNV ,who was diagnosed by examination of visual acuity ,intmocular pressure ,ocular fundus ,fundus fluorescein angi‐ography (FFA) ,and optic coherence tomography(OCT) ,and who underwent PDT combined with intravitreal injection of Lucentis . Results At the 4 ~ 6 months follow‐up ,the best corrected visual acuity(BCVA) improved in 22 eyes(73 .3% ) ,stabilized in 8 eyes (26 .7% ) and none decreased .Among the AMD ,14 cases(70 .0% ) required only a single combined treatment for CNV resolution ;3 cases of AMD needed retreatment 3 months later .In CNV group ,all of the cases required only a single combined treatment for CNV resolution .At the therapy and follow‐up period ,no ocular or systemic adverse reactions were noted .Conclusion The treatment of PDT combine intravitreal injection of Lucentis is safe and effective for CNV ,which could improve visual acuity and reduce retreat‐ment rates .

Efficacy of adjunctive intravitreous injection with Lucentis for neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the clinical efficacy of adjunctive intravitreous injection with Lucentis for the treatment of neovascular glaucoma ( NVG) . METHODS:The retrospective case series study included 25 eyes of 25 patients who underwentintravitreous injection with Lucentis. Patients firstly received an intravitreous injection with Lucentis (0. 5mg/0. 05mL), after the regression of neovascularization of the iris, patients accepted different surgical treatments according to different etiopathogenesis condition. Iris, chamber angle neovascularization condition, intraocular pressure, and visual acuity were observed postoperatively. The follow-up duration was 3mo. RESULTS:After 3-7d of intravitreous Lucentis injecting, iris and chamber angle neovascularization was totally faded in 20 cases (20 eyes) and was not completely faded in 5 cases ( 5 eyes ) . Additional treatments were compound trabeculectomy ( 14 cases, 14 eyes ) , vitrectomy ( 4 cases, 4 eyes ) . The patients' mean intraocular pressure was 43. 42 ± 10. 99mmHg before treatment, which decreased rapidly when they came out of the hospital (14. 26±7. 64mmHg, P CONCLUSION:Intravitreous injection with Lucentis can be used as an assisted treatment of NVG. According to different etiopathogenesis condition, it is an effective treatment to combine with other treatment methods for NVG.

Role of anti vascular endothelial growth factor (VEGF) in ophthalmology.

Vascular endothelial growth factor (VEGF), is a naturally occurring signal protein which is proinflammatory, stimulates angiogenesis and potent inducer of vascular permeability. Its role in normal physiology includes in embryonic development, wound healing and bone repair, neovascularization following MI and demonstrated in brain, kidney and GI mucosa. VEGF is responsible for many retinal diseases by causing new vessel growth and by increasing leakage and causing retinal swelling. Their use in ophthalmology includes in both anterior and posterior segment pathologies. This article explains the role of VEGFs, their mechanism of action, anti VEGFs, classification, their use, various studies and other aspects.

Intravitreal lucentis injection combined with macular grid photocoagulation for diabetic macular edema / 中国基层医药

Objective To observe the effect of intravitreal lucentis injection combined with macular grid photocoagulation for diabetic macular edema (DME).Methods 42 DME patients(42 eyes) according to different treatment methods,were divided into the combined group 21cases(21 eyes) and photocoagulation group 21 cases (21 eyes).The combined group was treated with connaught suitable for intravitreal injection combined macular grid photocoagulation , and the photocoagulation group was treated with simple macular grid photocoagulation .After 1 weeks,2 weeks,4 weeks,8 weeks,12 weeks and best corrected visual acuity before treatment (BCVA) and macular foveal thickness ( CMT) changes were comparative analyzed between the two groups .Results The BCVA values of the photocoagulation group before surgery ,1 week,2 weeks,4 weeks,8 weeks,12 weeks,were (0.74 ±0.24), (0.56 ±0.22),(0.52 ±0.23),(0.51 ±0.21),(0.51 ±0.20),(0.53 ±0.21),and CMT values were (440.36 ±50.56)μm,(376.06 ±28.60)μm,(365.45 ±30.02)μm,(361.38 ±29.56)μm,(358.68 ±30.46)μm,(360.43 ±29.36)μm;The BCVA values of the combined with preoperative group before surgery ,1 week, 2 weeks,4 weeks,8 weeks,12 weeks,were (0.70 ±0.23),(0.55 ±0.19),(0.52 ±0.18),(0.50 ±0.20), (0.48 ±0.19),(0.47 ±0.20),and CMT values were (442.32 ±54.35)μm,(385.14 ±27.34)μm,(345.32 ± 28.12)μm,(336.24 ±28.17)μm,(326.45 ±27.65)μm,(315.36 ±28.23)μm.The differences of BCVA and CMT values of the two groups in each time period values before and after treatment were statistically significant ( all P<0.05),and after 8 weeks,12 weeks,the differences of BCVA and CMT values between the two groups were statisti-cally significant(all P<0.05).Conclusion The macular grid photocoagulation only or lucentis injection combined with macular grid photocoagulation for diabetic macular could increase BCVA and reduce macular edema instinctively , but the difference was not significant .Combined therapy could preserve the visual acuity and delay time to relapse .

Macular Hole after Single Intravitreal Injection of Ranibizumab in a Patient with Age-Related Macular Degeneration

PURPOSE: To report a case of a full-thickness macular hole after a single intravitreal injection of ranibizumab in a patient with choroidal neovascularization associated with age-related macular degeneration. CASE SUMMARY: A 63-year-old woman presented to our department with gradually decreasing vision in her right eye. Best corrected visual acuity (BCVA) was measured as 0.7 in the right eye and 1.0 in the left eye. Examination of the macula showed a choroidal neovascularization associated with subretinal hemorrhage in the right eye. Optical coherence tomography (OCT) confirmed incomplete posterior vitreous detachment, subretinal hemorrhage and serous elevation. The patient subsequently received an intravitreal ranibizumab injection. After 1 month, the best corrected visual acuity in the right eye was decreased to 0.4, and fundus examination revealed posterior vitreous detachment and a macular hole. The patient underwent pars plana vitrectomy with internal limiting membrane peeling and fluid-air exchange, SF6 gas injection, phacoemulsification and posterior chamber intraocular lens implantation. Three months later, the macular hole had closed completely and best visual acuity was 1.0. CONCLUSIONS: Although the occurrence of a full-thickness macular hole after intravitreal ranibizumab injection is uncommon, physicians should be well acquainted with this complication.

Ranibizumab as an adjunct to laser for macular edema secondary to branch retinal vein occlusion.

To compare the safety, efficacy, and dosing regimen of intravitreal ranibizumab as an adjunct to laser therapy for the treatment of macular edema secondary to branch retinal vein occlusion (BRVO). Materials and Methods: Thirty eyes of 30 patients of BRVO of at least 6 weeks duration were randomized into three groups: Group 1 received grid laser treatment alone, Group 2 received a single dose of intravitreal injection of ranibizumab (0.5 mg / 0.05 ml) followed by grid laser treatment on 7th day following injection, while Group 3 received three loading doses of intravitreal ranibizumab at monthly interval (i.e. 0, 1, & 2 months) + standard laser treatment 7 days after the 1st injection. Outcome measure noted at 6 months follow-up were the improvement in best-corrected visual acuity (BCVA) and central macular thickness (CMT). Results: At 6 months follow-up, there was an average gain of 12 letters (P=0.05), 17.5 letters (P=0.05) and 19 letters (P=0.05) in groups 1, 2, and 3, respectively, with the decrease in CMT being 208.7 μm (P=0.05), 312.9 μm (P= 0.05) and 326.8 μm (P=0.05), respectively, in these groups. Gain in BCVA of more than 3 lines was noted in 1/10 patients in Group 1(10%) as compared to 3/10 (30%) and 4/10 (40%) patients in groups 2 and 3, respectively. Conclusion: The gain in BCVA and reduction in CMT were better with combination therapy (single- and triple- dose regimen) compared to grid laser alone. Single dose of intravitreal ranibizumab with grid laser seems to be an effective therapy.

Flare up of choroiditis and choroidal neovasculazation associated with punctate inner choroidopathy during early pregnancy.

A 28-year-old, healthy female, who had a recent repeated history of miscarriage, presented with bilateral choroidal neovascular membranes (CNVM), for which she received photodynamic therapy with three doses of lucentis, at intervals of one month each, to which she responded. After five months, the patient again presented with complaints of diminution of vision since 15 days. She had a history of miscarriage two days before presenting to our clinic. CNVM was scarred at this time and the fundus picture showed multiple small punctate spots around the fovea at the level of the choroid, which showed early hyperfluroscence on fundus fluorescein angiography, suggestive of punctate inner choroidopathy. She was advised systemic steroids, to which she responded dramatically.

Short-term Efficacy of Intravitreal Ranibizumab for Myopic Choroidal Neovascularization

PURPOSE: To evaluate the effects of intravitreal ranibizumab in myopic choroidal neovascularization (CNV). METHODS: Patients who underwent intravitreal ranibizumab injection for myopic CNV, and were followed up more than 6 months, and their records were retrospectively investigated. The best corrected visual acuity, central macular thickness, and leak in fluorescein angiography were compared at baseline, and at 1, 3, and 6 months after injection. RESULTS: Twenty-one eyes of 18 patients were evaluated. The mean best corrected visual acuity (logMAR) was 1.23+/-0.65, 0.96+/- 0.40, 0.95+/-0.67, and 0.83+/-0.58 at baseline, 1, 3, and 6 months, respectively (p<0.001, p=0.006, p=0.001). The mean central macular thickness was 233.42+/-65.55 microm, 204.14+/-65.29 micrometer, and 157.76+/-71.45 microm at baseline, 3, and 6 months, respectively (p<0.001). In fluorescein angiography at 6 months after injection, regression was observed in 12 eyes, and fibrosis in 9 eyes. CONCLUSIONS: Intravitreal ranibizumab injection for myopic CNV in Korean patients appeared to be effective, resulting in regression of lesion and improvement of visual acuity.