Visual acuity outcomes in ranibizumab-treated neovascular age-related macular degeneration; stratified by baseline vision

Background: Ranibizumab (Lucentis, Novartis, Basel, Switzerland) is currently indicated for use in neovascular age‐related macular degeneration (NVAMD). This study assessed the real‐life outcomes based on baseline visual acuity when treated with intravitreal ranibizumab on a three + pro re nata (PRN) dosing schedule for NVAMD. Design: This retrospective chart‐review was conducted at King's College Hospital. The patients were stratified into three groups based on baseline Early treatment diabetic retinopathy study (ETDRS) letters: 27 with poor visual acuity (24–34 letters), 33 with intermediate visual acuity (35–54 letters) and 27 with good visual acuity (≥=55 letters). Methods: All patients received a three + PRN dosing schedule of ranibizumab injections (0.5 mg per 0.05 mL) based on changes in visual acuity and macular thickness on optical coherence tomography (OCT) and all patients completed 12‐month follow up. Main Outcome Measures: The mean change in visual acuity at 12 months in the three groups. Results: Mean gain in ETDRS letters at 12 months was +14.00 (P < 0.0001), +7.10 (P = 0.012) and +2.85 (P = 0.19), and mean number of injections was 5.30, 6.12 and 5.70 in the poor, intermediate and good baseline vision group, respectively, over the 12‐ month follow‐up period. Conclusions: Poor baseline visual acuity (24–34 ETDRS letters) is a predictor of maximum gain in visual acuity. However, eyes with better baseline visual acuity (55 letters) had a better final visual acuity.