Ranibizumab en miopia 12m (2)
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This document discusses the use of ranibizumab (Lucentis) to treat choroidal neovascularization (CNV) secondary to pathologic myopia. It summarizes several case studies on the effects of ranibizumab treatment for myopic CNV. A series of 23 patients with myopic CNV who received ranibizumab treatment showed a mean visual acuity gain of 9.53 letters after 12 months. Most patients (77%) gained over 1 line of vision. No patients experienced moderate vision loss. The results suggest ranibizumab may effectively prevent vision loss and improve vision for CNV caused by pathologic myopia with very few needed treatments and no observed safety risks.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Ranibizumab en miopia 12m (2)
- 1. jmones@institutmacularetina.com RANIBIZUMAB in CNV secondaryto PATHOLOGIC MYOPIA Jordi Monés Institut de la Màcula i de la Retina CM Teknon, Barcelona
- 2. jmones@institutmacularetina.com New era of expectations in AMD from 2005 …alsoforother causes of CNV….
- 3. First cases reported: SystemicBevacizumab in myopic CNV: Dec 2005 jmones@institutmacularetina.com Nguyen QD, Shah S, Tatlipinar S, Do DV, Anden EV, Campochiaro PA. Bevacizumabsuppresseschoroidalneovascularisationcausedbypathologicalmyopia. Br J Ophthalmol. 2005 Oct;89(10):1368-70. No abstractavailable.
- 8. Mean visual gain: 3,5 lines
- 10. Results at 12 months 1 dropout, 22continue ( follow-up 95%) 22 out of 23reached at leastfollow-up12m Mean visual gain: 9,53 letters, 2 lines( from 20/64 to 20/40) Mean # of treatments: 1,5 jmones@institutmacularetina.com
- 11. Results at 12 months Gain in naiveeyes: +12,78 letters Gain in pretreatedeyes: +7.43 letters Gain in <50 yearsold+12letters Gain in >50 yearsold+7,25 letters onlyoneinjection73%
- 12. Results at 12 months No moderate visual loss: 100% (22/22)
- 13. Results at 12 months Losslessthan 3 lines: 13% ( 3/22) Gain>0 lines87% (19/22) Gain>1 lines77% (17/22) Gain>3 lines27% (6/22)
- 14. Mujer 74 años, -10d, 20/125 juliol 20/125 20/64 20/50 20/64 20/50
- 15. Mujer 17 años -5d, 20/32 M 2,5 20/20 M 1 20/25 M 4 20/50 M 5 20/40 M 8 20/20 20/ 32
- 16. G varón 79 años , -15D, 20/125 20/125 20/40 20/40 20/32 20/32
- 17. Adverse Events No RD, no endophtalmitis No evidence of induced or exagerated atrophy 1 patient with angina, probably related to severe anemia jmones@institutmacularetina.com
- 18. Summary This short serie of 22 patients with 12 months follow-up suggest that PRNranibizumabmay be both effectiveinpreventing visual loss and in gainingvisual acuity in CNV 2ry to myopia Number of needed treatments may be very low, but is a must to continue follow-up for late recurrences Although impossible to obtain safety data from such a sort serie, the results suggest no specific risks for patients with pathologic myopia jmones@institutmacularetina.com