Ranibizumab For Choroidal Neovascularization Associated With Adult-onset Foveomacular Vitelliform Dystrophy: One-year Results

Purpose:To evaluate the efficacy of intravitreal injections of ranibizumab for choroidal neovascularization associated with adult-onset foveomacular vitelliform dystrophy (AOFVD). Methods:Non-randomized, double-center, retrospective cases series of 24 eyes affected with choroidal neovascularization associated with AOFVD treated by intravitreal injections of ranibizumab (0.5 mg/0.05 ml). Best-corrected visual acuity (BCVA), fundus examination, spectral domain-optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), fluorescein angiography (FA) and indocyanine green angiography (ICGA) were performed for the diagnosis of AOFVD and choroidal neovascularization. After initial treatment course of 3 monthly intravitreal injections of ranibizumab (loading phase), patients were followed up monthly and received further intravitreal injections in case of persistent neovascular activity. The primary end point was the proportion of patients losing fewer than 3 lines from baseline visual acuity at 12 months. Results:At month-12, mean number of intravitreal ranibizumab injections was 4.5 ± 1.29. Mean BCVA did not change significantly form baseline to month-12 (0.37 ± 0.2 logMAR vs 0.30 ± 0.25 logMAR, respectively; p = 0.115). Overall, BCVA stabilized or improved in 21/24 eyes (87.5%). Mean central macular thickness significantly decreased form baseline to month-12 (327 ± 83 µm vs 260 ± 57 µm, respectively; p = 0.001). Conclusions:In the current series, intravitreal ranibizumab succeeded in stabilizing BCVA in patients with CNV associated with AOFVD. Ranibizumab seems to be a reasonable therapeutic option in this condition. Further prospective multicentric clinical trials are needed to evaluate the safety and the efficacy of this treatment.