INTRAVITREAL RANIBIZUMAB FOR CHOROIDAL NEOVASCULARIZATION WITH LARGE SUBMACULAR HEMORRHAGE IN AGE-RELATED MACULAR DEGENERATION

Purpose: To evaluate the effects of intravitreal ranibizumab injections in the treatment of choroidal neovascularization with large submacular hemorrhage secondary to age-related macular degeneration. Methods: Prospective interventional case series. Patients presenting occult choroidal neovascularization with flat large submacular hemorrhage > 50% of the entire lesion were considered. The protocol required 3 monthly consecutive injections, followed by repeat injections over the 12-month follow-up on the basis of optical coherence tomography parameters and angiographic features. Results: Twenty-three patients were enrolled in the study and prospectively followed up. Mean best-corrected visual acuity and mean central macular thickness at the baseline were 0.82 +/- 0.22 (logarithm of the minimum angle of resolution +/- standard deviation) and 342 +/- 56 mm, respectively. At 12-month examination, mean visual acuity improved significantly to 0.68 +/- 0.41 (P = 0.04), and mean central macular thickness decreased to 236 +/- 26 mm (P, 0.0001). A progressive resolution of macular bleeding was registered in 22 of 23 patients. No side effect or complication was registered. Conclusion: Intravitreal ranibizumab can be considered a beneficial approach for the management of choroidal neovascularization with flat large submacular hemorrhage secondary to age-related macular degeneration.