Intravitreal Ranibizumab for Predominantly Hemorrhagic Choroidal Neovascularization in Age-Related Macular Degeneration

Purpose: To evaluate the effects of intravitreal ranibizumab monotherapy on predominantly hemorrhagic choroidal neovascularization with foveal involvement associated with age-related macular degeneration. Materials and Methods: Twenty-two consecutive eyes with hemorrhagic neovascularization were treated with 3 monthly intravitreal ranibizumab injections. Additional injections were administered according to retreatment criteria during 12 months of follow- up. Results: A mean of 6.64 +/- 1.36 injections was administered. Overall, the mean visual acuity increased from 10.90 +/- 6.02 to 12.81 +/- 8.34 ETDRS letters (p > 0.05) at 12 months. The 'early treatment group' gained a mean of 2.83 +/- 2.24 ETDRS letters (p < 0.05), while the 'late treatment group' gained a mean of 0.30 +/- 1.25 ETDRS letters (p > 0.05) with significant differences between the groups (p < 0.05). A progressive resolution of macular bleeding was registered in 20 patients (mean time: 5.3 +/- 1.6 months). Conclusions: Ranibizumab injections can be considered a beneficial approach for the management of predominantly hemorrhagic choroidal neovascularization with foveal involvement associated with age-related macular degeneration. Furthermore, the time interval between hemorrhage and the first injection seems to be an important predicting factor of final visual acuity. (C) 2015 S. Karger AG, Basel