TY - JOUR
T1 - Tachyphylaxis during treatment of exudative age-related macular degeneration with ranibizumab.
AU - Eghøj, Maria S
AU - Sørensen, Torben Lykke
PY - 2012/1
Y1 - 2012/1
N2 - Aim: To determine whether tachyphylaxis occurs during treatment with ranibizumab (Lucentis, Genentech, Inc., South San Francisco, California, USA) for exudative age-related macular degeneration (AMD). Design: Retrospective review of cases. Participants: The treatment results of 1076 eyes (976 patients) treated with ranibizumab for exudative AMD was evaluated to identify patients with a potential tachyphylactic response. The participants had to have a minimum of 12 months follow-up. Methods: Tachyphylaxis was defined as a lack of response to the drug at the time of reactivation of choroidal neovascularisation (CNV) in patients who had responded to the initial treatment. The authors considered it a lack of response to ranibizumab if a decrease in vision and an increase in central retinal thickness (CRT) were observed despite repeated injections. Hence a stabilisation in vision and/or stabilisation in CRT during treatment were not considered tachyphylaxis, and other unfavourable responses such as a tear in the retinal pigment epithelium and therefore a decrease in vision during treatment were also not considered as tachyphylaxis. Every patient in this cohort who has had an injection-free interval after primary inactivation of CNV and who has received retreatment at a later stage was identified. In this population, those cases that did not respond to retreatment (tachyphylaxis) were identified and characterised. Main outcome measures: Number of patients who developed tachyphylaxis after treatment with ranibizumab. Results: 20 patients (2%) developed tachyphylaxis during their treatment. Conclusion: Tachyphylaxis can occur during the treatment of exudative AMD with ranibizumab. The precise mechanism for the development of tachyphylaxis is unclear. Both local and systemic factors might be involved.
AB - Aim: To determine whether tachyphylaxis occurs during treatment with ranibizumab (Lucentis, Genentech, Inc., South San Francisco, California, USA) for exudative age-related macular degeneration (AMD). Design: Retrospective review of cases. Participants: The treatment results of 1076 eyes (976 patients) treated with ranibizumab for exudative AMD was evaluated to identify patients with a potential tachyphylactic response. The participants had to have a minimum of 12 months follow-up. Methods: Tachyphylaxis was defined as a lack of response to the drug at the time of reactivation of choroidal neovascularisation (CNV) in patients who had responded to the initial treatment. The authors considered it a lack of response to ranibizumab if a decrease in vision and an increase in central retinal thickness (CRT) were observed despite repeated injections. Hence a stabilisation in vision and/or stabilisation in CRT during treatment were not considered tachyphylaxis, and other unfavourable responses such as a tear in the retinal pigment epithelium and therefore a decrease in vision during treatment were also not considered as tachyphylaxis. Every patient in this cohort who has had an injection-free interval after primary inactivation of CNV and who has received retreatment at a later stage was identified. In this population, those cases that did not respond to retreatment (tachyphylaxis) were identified and characterised. Main outcome measures: Number of patients who developed tachyphylaxis after treatment with ranibizumab. Results: 20 patients (2%) developed tachyphylaxis during their treatment. Conclusion: Tachyphylaxis can occur during the treatment of exudative AMD with ranibizumab. The precise mechanism for the development of tachyphylaxis is unclear. Both local and systemic factors might be involved.
U2 - 10.1136/bjo.2011.203893
DO - 10.1136/bjo.2011.203893
M3 - Journal article
C2 - 21733918
SN - 0007-1161
VL - 96
SP - 21
EP - 23
JO - British Journal of Ophthalmology
JF - British Journal of Ophthalmology
IS - 1
ER -