Time to first treatment: The significance of early treatment of exudative age-related macular degeneration

Retina. 2012 Jul;32(7):1260-4. doi: 10.1097/IAE.0b013e3182018df6.


Purpose: To determine whether the time span between initial symptoms and treatment with ranibizumab in patients with neovascular age-related macular degeneration has an effect on visual outcome.

Method: In this retrospective study, 45 patients with exudative age-related macular degeneration were split into 3 groups depending on the duration of visual symptoms--Group I: <1 month, Group II: 1 month to 6 months, and Group III: >6 months. Best-corrected visual acuity, clinical ophthalmologic examination, and central retinal thickness as measured by optical coherence tomography were recorded at baseline and 2 months later. Fluorescein angiography was performed at baseline. Treatment consisted of 2 intravitreal injections of 1.25 mg of ranibizumab at baseline and after 4 weeks.

Results: The mean time span between initial symptoms and treatment was 59 ± 62 days. In all groups, a reduction of retinal thickness was observed. Shorter disease duration, as estimated by persistence of visual symptoms, was correlated with a better visual outcome after treatment. Patients in Group I demonstrated a significant increase in best-corrected visual acuity (P = 0.007). Patients of Group II (P = 0.095) and Group III (P = 0.271) still achieved a visual improvement in best-corrected visual acuity, albeit not significant. The mean change in best-corrected visual acuity was 0.08 ± 0.1 in all patients and was not statistically significant between groups (P = 0.87).

Conclusion: Duration of visual symptoms <1 month before treatment is associated with a better visual outcome. Treatment of new-onset wet age-related macular degeneration should be initiated as soon as possible.

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / administration & dosage*
  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Exudates and Transudates
  • Female
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Male
  • Ranibizumab
  • Retina / pathology
  • Retrospective Studies
  • Secondary Prevention
  • Time Factors
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology
  • Wet Macular Degeneration / diagnosis
  • Wet Macular Degeneration / drug therapy*
  • Wet Macular Degeneration / physiopathology


  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Ranibizumab