Choroidal neovascularisation complicating geographic atrophy in age-related macular degeneration

Objective To investigate the morphological and functional outcomes after intravitreal ranibizumab injections for choroidal neovascularisation (CNV) complicating geographic atrophy (GA). Design Retrospective, interventional, consecutive case series. Methods We reviewed the charts of all consecutive patients with GA due to age-related macular degeneration (AMD), who received intravitreal ranibizumab injections for the development of CNV at least 24 months earlier. Results 21 treatment-naive eyes of 21 consecutive patients (4 men, 17 women, mean age 86.9 +/- 1.6 years) were included. In 95.2% of eyes a type 2 CNV was present, extrafoveal in 42.8% of cases. After a mean of 5.0 +/- 0.87 (range 1-20) intravitreal ranibizumab injections, best-corrected visual acuity (BCVA) significantly worsened at the 24-month follow-up visit (0.73 +/- 0.05 vs 0.88 +/- 0.08 logMAR, respectively; p=0.01). A significant reduction of intraretinal cystic lesions, subretinal fluid and pigment epithelium detachment (p<0.001) and a significant increase of GA area (p=0.003) were present at last visit. Conclusions Ranibizumab treatment of GA-associated CNVs provides no BCVA improvement at 24 months follow-up despite an anatomic response of CNV. Low effectiveness of ranibizumab in these cases is likely due to GA progression.