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- Title
Two-year results for ranibizumab for radiation retinopathy (RRR): a randomized, prospective trial.
- Authors
Yu, Hannah J.; Fuller, Dwain; Anand, Rajiv; Fuller, Timothy; Munoz, Jose; Moore, Chelsey; Kim, Ryan S.; Schefler, Amy C.; the RRR Study Group; Bretana, Maria E.; Diugnan, Karen
- Abstract
Purpose: To assess the efficacy of a treat-and-extend strategy with intravitreal ranibizumab for radiation-related macular edema. Methods: Forty eyes with radiation-induced macular edema and decreased visual acuity were enrolled in the phase IIb, prospective clinical trial and randomized into 3 cohorts: (A) monthly ranibizumab, (B) monthly ranibizumab with targeted retinal photocoagulation (TRP), or (C) as-needed ranibizumab and TRP. In year 2, all subjects entered a treat-and-extend protocol for ranibizumab. The primary outcome measure was mean change in early treatment diabetic retinopathy study (ETDRS) best-corrected visual acuity (BCVA) from baseline. Results: Through year 1, the mean change in ETDRS BCVA was significantly different between the three cohorts (p < 0.001); cohort A saw the largest gain with + 4.0 letters. Significant anatomic improvements were also seen in all cohorts. Comparatively, through year 2, cohorts A, B, and C had a mean change in ETDRS BCVA of − 1.9, − 3.9, and + 1.3 letters, respectively; additionally, no significant differences were found in absolute ETDRS BCVA across time (ANOVA, p = 0.123). Overall, 90% of eyes maintained VA 20/200 or better and 33.3% of subjects gained at least one line of vision. There were no significant differences in mean central macular thickness for any cohort compared to baseline (p = 0.09). The presence of retinal hemorrhage and intraretinal exudates stayed consistent from year 1 to year 2 for all cohorts. Conclusions: Among eyes with radiation-related macular edema, a treat-and-extend regimen with ranibizumab may not result in as many visual and anatomic improvements as monthly injections. However, treat-and-extend still may prevent serious visual complications compared to historical controls. Trial registration: ClinicalTrials.gov Identifier: NCT02222610
- Subjects
RANIBIZUMAB; LASER photocoagulation; MACULAR edema; DIABETIC retinopathy; VISUAL acuity; ENDOTHELIAL growth factors
- Publication
Graefe's Archive of Clinical & Experimental Ophthalmology, 2022, Vol 260, Issue 1, p47
- ISSN
0721-832X
- Publication type
Article
- DOI
10.1007/s00417-021-05281-2