RESUMO
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Assuntos
Humanos , Masculino , Feminino , Edema Macular/complicações , Edema Macular/diagnóstico , Edema Macular/terapia , Diabetes Mellitus , Baixa Visão/diagnóstico , Baixa Visão/terapia , Inibidores da Angiogênese , Qualidade de Vida , Injeções Intravítreas/instrumentação , Injeções Intravítreas/métodos , Injeções Intravítreas , Ranibizumab/administração & dosagem , Ranibizumab/farmacologia , Ranibizumab/uso terapêutico , Tomografia de Coerência Óptica/instrumentação , Tomografia de Coerência Óptica/métodos , Tomografia de Coerência Óptica , Estudos Prospectivos , Estudos Longitudinais , Inquéritos e QuestionáriosAssuntos
Inibidores da Angiogênese/uso terapêutico , Retinopatia Diabética/tratamento farmacológico , Edema Macular/tratamento farmacológico , Qualidade de Vida , Ranibizumab/uso terapêutico , Baixa Visão/tratamento farmacológico , Indicadores Básicos de Saúde , Humanos , Estudos Longitudinais , Edema Macular/etiologia , Estudos Prospectivos , Resultado do Tratamento , Baixa Visão/etiologiaRESUMO
BACKGROUND: The study aims to survey longstanding funduscopic and functional outcomes of age-related macular degeneration (AMD) after ranibizumab treatment and verify the accuracy of a new method to compare the retinal thickness measured with different optical coherence tomography (OCT) tools. METHODS: Case series included 314 eyes with 2-4 years of follow-up. Main Outcome Measures were visual acuity (VA), number of injections, retinal thickness, OCT morphology, and final macular funduscopic status. RESULTS: One hundred twenty-two men and 177 women (mean age, 78.3 years) were included. The mean time to the first injection was 17.3 ± 14.6 days. Initial VA was O.8(20/125) ± 0.5; 0.7(20/100) ± 0.5 at 3 months; 0.8(20/125) ± 0.5 at a year; 1(20/200) ± 0.6 at year 2; 1(20/200) ± 0.6 at year 3 and 1.1(20/250) ± 0.6 at year 4. Number of visits at 3 months was 2.7 ± 0.8; 7.3 ± 2.1 at a year; 5.2 ± 2.7 along the 2nd year; 3.9 ± 2.3 at year 3 and 3.6 ± 2.2 at year 4. Number of injections at 3 months was 2.6 ± 0.5; 3.9 ± 1.5 at a year; 1.1 ± 1.5 along the 2nd year; 1.5 ± 2.4 at year 3 and 1.8 ± 3.1 at year 4. Patients with worse VA outcomes received more injections and were older. The formula to calculate changes in retinal thickness showed a 30% reduction in thickness, which correlated well with the OCT morphology. Patients with polypoidal choroidal vasculopathy (PCV) had a worse final outcome. The final disciform macular status (37%) was related to fewer injections and a greater decrease in thickness. Final well-preserved maculas (12.%) needed more injections and treatment changes; those that were atrophic at the final visit (30.8%) had a worse initial VA and greater decrease in thickness at the 3-month visit. CONCLUSIONS: Younger patients had better final outcomes. Our method to compare retinal thickness using different OCT tools worked well. The final visual outcome after a long follow-up was poor, which may be related to advanced age, poor initial VA, and the high incidence of final fibrosis or atrophy.
