Ranibizumab therapy for predominantly hemorrhagic neovascular age-related macular degeneration

Predominantly hemorrhage represents one of the possible manifestations of choroidal neovascularisation (CNV) in eyes with age-related macular degeneration (AMD). The purpose of this study is to evaluate the effecte of ranibizumab treatment in patients with predominantly hemorrhagic CNV secondary to AMD.

Twenty-five patients with predominantly hemorrhagic choroidal neovascularization due to AMD with at least three ranibizumab injections and followed up for at least 12 months were included in the study. The months of follow-up were recorded (baseline, 3^rd, 6^th, and 12^th months). The change in central macular thickness (CMT) on optical coherence tomography, visual acuity (VA) in ETDRS letters, and lesion size on fundus fluorescein angiography were evaluated.

The mean age of the patients was 68.1±5.7 (range: 63-82) years, the mean follow-up was 19.9±14.5 (range: 12-67) months, and the mean number of injections was 4.0±1.4 (range: 3-15). The initial VA was 39.3±17.9 (range: 1-65) letters, CMT was 272.7±104 (range: 164-587) μm, and the initial lesion width was 11.4±10.5 (range: 1.3-45.7) mm². The VA was 41.4±20.1 (range: 5-75) and 36.9±21.8 (range: 4-80) letters (p=0.150), CMT was 270.7±110 (range: 159-570) and 230.4±108 (range: 109-667) μm (p=0.009) and the lesion width was 10.9±11.5 (range: 1.1-39.7) and 10.4±11.6 (range: 1.2-44.3) mm² at 6^th and 12^th month, respectively. No factor was found to be associated with final CMT.

Although the final visual outcome is limited by the progression of the disease, hemorrhagic lesions treated with ranibizumab have stable anatomical outcome.