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Vitreous separation in wet AMD patients linked to fewer anti-VEGF injections
The presence of vitreous separation may play a role in ranibizumab therapy for neovascular age-related macular degeneration, according to a poster presented at the Association for Research in Vision and Ophthalmology meeting here.
Previous studies showed that bevacizumab injections in animal eyes had a slower rate of retinal penetration when the vitreous was attached to the anterior retina surface. The presence of vitreous separation may reduce the number of injections needed because of better retinal penetration or increase the number of injections needed because of less of the drug remaining in the vitreous cavity, the authors hypothesized.
“We’re really excited about this trend and, hopefully, especially with all the medications … if we can get something upfront that, overall, [reduces injections], it would be worthwhile on many levels: economic, patient comfort, etc.,” Lisa J. Faia, MD, the lead author, said in an interview with Ocular Surgery News.
The prospective study included 33 patients with neovascular AMD. Patients were assigned to groups based on presence of posterior vitreous detachment (PVD) and followed for 1 year. They received 0.5 mg injections of Lucentis (ranibizumab, Genentech) monthly for 3 months and subsequent re-injections on an as-needed basis.
At baseline, 18 patients had PVD and 15 did not.
The average number of injections was 8.4 in the PVD group and 9.44 in the non-PVD group.
The non-PVD group had 2.05 times greater odds of getting at least one injection than the PVD group, the authors said.
At 6 months, four patients in the non-PVD group had converted to PVD, for a total of 22 patients with PVD at 1 year.
Further prospective studies with larger patient samples are needed to fully gauge the impact of vitreous separation on neovascular AMD treatment, Faia said.