Ranibizumab treatment administered as needed for occult and minimally classic neovascular membranes in age-related macular degeneration

Purpose: To report the clinical experience of intravitreal ranibizumab administered as needed for the treatment of neovascular age-related macular degeneration (AMD). Methods: We retrospectively reviewed the charts of 41 patients (41 eyes) with occult and minimally classic neovascular membrane in AMD. Patients received intravitreal injections (0.5 mg) of ranibizumab and were monitored monthly for 12 months. Forty-one eyes were retreated at the discretion of the treating physician on an as-needed basis after the first injection, instead of initially giving three monthly injections. The main outcomes measured were change in mean visual acuity and central retinal thickness, and the total number of injections received by patients during the 12 months. Results: At 12 months, the mean logarithm of the minimum angle of resolution (logMAR) visual acuity improved by 0.078 logMAR units (P = 0.046) and the mean central retinal thickness decreased by 85.7 μm (P < 0.001). Thirty of 41 eyes (73.2%) avoided any loss of vision, and 20 eyes (48.8 %) showed improved visual acuity. A mean of 4.07 injections were given over the 12 months. Conclusions: Ranibizumab administered on an as-needed basis may stabilize visual acuity in patients with neovascular AMD.