Epimacular brachytherapy safely reduced ranibizumab re-treatments for up to 1 year in patients with neovascular age-related macular degeneration, according to a study.
The MERITAGE trial included 53 patients previously treated for neovascular AMD who underwent pars plana vitrectomy with a single dose of epimacular brachytherapy and subsequent monthly re-treatment with ranibizumab as needed. Two-year data included 47 patients.
Criteria for ranibizumab re-treatment were a 10-letter reduction of visual acuity, a 50-µm increase in central retinal thickness, new macular hemorrhage or new activity visible on fundus fluorescein angiography.
Primary outcome measures were the percentage of patients who lost fewer than 15 ETDRS letters of best corrected visual acuity and mean number of ranibizumab re-treatments at 24 months.
Over the 24-month period, 68.1% of patients lost fewer than 15 letters, with a mean 8.7 ranibizumab re-treatments. Mean loss of visual acuity was 6.3 letters at 24 months.
Patients required 0.50 ranibizumab injections per month in the 12 months before enrollment, 0.29 injections per month in the first 12 months after brachytherapy and 0.44 injections per month in the second 12 months after laser treatment, according to the researchers. On average, each patient required 0.36 injections per month during the entire 24 months.
One case of nonproliferative radiation retinopathy was reported. Subconjunctival hemorrhage occurred in 38 patients, cataract development or progression in 22 patients, vitreous hemorrhage in six patients and ocular pain or discomfort in five patients.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.