Background: Intravitreal ranibizumab (Lucentis®) is an effective treatment for exudative age-related macular degeneration (AMD). Up to now, settlement for this therapy remains quite complex and is handled differently by insurance companies as well as in the different German states. Often applications must be submitted and approved before an injection can be made. This procedure is time consuming and a delay in starting treatment might result. The aim of this study was to determine the effect of late-onset injection on visual acuity before and during the upload procedure.
Methods: All patients treated with ranibizumab intravitreally between February 2007 and May 2010 were retrospectively evaluated for their best-corrected visual acuity at the day of diagnosis, injections during the upload phase and first follow-up visit after upload.
Results: A total of 1,149 eyes were evaluated and divided into 2 groups according to time between diagnosis and first injection (group 1: ≤10 days, group 2: >10 days). There was no statistically significant difference between the groups for average age, gender, visual acuity at day of diagnosis and type of choroidal neovascularisation. However, both groups differed in the loss of visual acuity before the first injection and the possible increase in visual acuity. Group 1 waiting ≤10 days showed - in contrast to group 2 waiting >10 days--a smaller loss of visual acuity before upload and greater gain of visual acuity during upload. Those differences were statistically significant.
Conclusion: Successful treatment of exudative AMD requires small intervals between diagnosis and first ranibizumab injection. After diagnosis, the first injection with ranibizumab should be given as early as possible.