Intravitreal Ranibizumab for Subfoveal Choroidal Neovascularization from Age-Related Macular Degeneration with Combined Severe Diabetic Retinopathy

Background: To evaluate the efficacy of intravitreal ranibizumab for subfoveal choroidal neovascularization (CNV) from agerelated macular degeneration (AMD) with combined severe diabetic retinopathy (DR). Methods: This retrospective, interventional case series included eleven patients (mean age, 70.09 years; range, 54 to 83 years) with at least severe non-proliferative DR and subfoveal CNV secondary to AMD. Each subject was treated with intravitreal injections of 0.5 mg ranibizumab. The primary outcomes included change in best-corrected visual acuity and central subfield thickness (CST) on optical coherence tomography (OCT). Results: The mean follow-up time was 16.7 +/- 14 months (range, 6 to 31 months). Mean visual acuity improved from 1.21 +/- 0.80 logarithm of the minimum angle of resolution (logMAR) to 1.0 +/- 0.6 logMAR (P=0.107), 0.95 +/- 0.62 logMAR (P=0.044), 1.10 +/- 0.68 logMAR (P=0.296), and 1.13 +/- 0.66 logMAR (P=0.838) at 1, 3, 6, and 12 months after injection, respectively. Eight patients (72.7%) gained or maintained vision (mean 0.32 logMAR), whereas three patients (27.3%) lost more than one line of vision (mean 0.51 logMAR). The mean OCT CST was 343.9 +/- 134.6 mu m at baseline, and the mean CST at 1, 3, 6, 12 months after the injection was 367.8 +/- 172.1 (P=0.864), 346.2 +/- 246.2 (P=0.857), 342 +/- 194.1 (P=0.551), and 294.2 +/- 108.3 mu m (P=0.621), respectively. Conclusion: Intravitreal ranibizumab injection can be considered to be a therapy for the stabilization of subfoveal CNV secondary to AMD with combined severe DR. However, these patients might exhibit limited visual improvement after treatment.