The Effect of Ranibizumab on Eye Lens Opacity in Cases With Age-Related Macular Degeneration

Purpose To evaluate the cataractogenic effect of intravitreal ranibizumab with the use of Lens Opacity Classification System III (LOCS III).

Settings Cases with a diagnosis of wet AMD were included in this university practice based prospective study.

Methods All cases had monthly injections of intravitreal ranibizumab in the first 3 months; subsequently an OCT-guided pro re nata injection regimen has been adopted. All cases had a comprehensive eye examination and LOCS III evaluation at baseline and 1, 3, 6 and 12 months after the initial injection. Examination outcomes and change from baseline in LOCS III grades at 12 months were recorded.

Results Eighteen eyes of 13 cases (7 female, 6 male) were included in this study. The mean age at the baseline was 75,3 + 6,6 years. A mean of 3,4 + 0,7 injections were given on each eye. Mean follow-up was 13,83 + 2,33 months. Baseline mean visual acuity improved from 1,04 + 0,10 logMAR units to 0,76 + 0,26 logMAR units after 3 injections (P < 0.05). At the 12th month of follow-up mean visual acuity was 0,71 + 0,27 logMAR units. According to LOCS III grades none of the cases had a prominent change in nuclear color, nuclear opalescence, cortical and posterior subcapsular opacification throughout the follow-up. IOP remained stable at all follow-up points. No complications were recorded throughout the study.

Conclusion Intravitreal ranibizumab is an efficient treatment in wet AMD. Results of LOCS III assessments in this pilot study suggest that intravitreal ranibizumab has no effect on the progression of lens opacity.

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Key information

Conditions

Age-Related Macular Degeneration Cataract Eye Diseases Lens Diseases Macular Degeneration Retinal Degeneration Retinal Diseases

Age range

55 year–85 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Uludag University School of Medicine, Department of Ophthalmology

Bursa, 16059, Turkey (Türkiye)

About this study

In the last decade, significant progress has been made in the treatment of wet AMD. At the present intravitreal anti-VEGF therapy has become the mainstay of treatment. Nevertheless, intravitreal application is a hazardous procedure with a wide range of complications. Endophthalmitis, intraocular pressure (IOP) elevation, retinal detachment, vitreous hemorrhage, and cataract are among the major complications.

The current study is focused on the cataractogenic potential of intravitreal ranibizumab. Cataract formation following intravitreal application is frequently associated with an inadvertent trauma at the procedure. However, occasionally the drug -itself- may precipitate cataract formation. Accelerated formation of cataract, has previously been shown as a possible cause of decreased visual acuity, in some cases who received intravitreal injections of triamcinolone. However, no prospective study has, as yet, assessed anti-VEGF agent related cataract progression in cases of AMD. Herein, the investigators have investigated the cataractogenic effect of intravitreal ranibizumab by using the Lens Opacity Classification System III (LOCS III).

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Neovascular age-related macular degeneration cases undergoing ranibizumab treatment
Phakic patients

Exclusion criteria

History of previous injections of a triamcinolone or anti-VEGF drug
Individuals that had undergone cataract extraction
Cases that had other intraocular surgery within the last 3 months
Cases that had any laser treatment within 1 month (including YAG laser iridotomy)
Cases that are using systemic steroids or anti-glaucomatous drops

Treatment and study plan

Primary outcomes

Lens Opacity Classification System (LOCS) III grades

Time frame: Change from baseline in LOCS III grades at 12 months are recorded.

Evaluation of lens status are assessed according to LOCS III standards. Attributes of LOCS III; nuclear color (NC), nuclear opalescence (NO), cortical opacity (CO), and posterior subcapsular opacity (PSC) are graded for each eye. Each attribute range from 0.1 (clear) to 6.9 (most advanced) in 0.1 increments.Change from baseline in LOCS III grades at 1 month, 3 months, 6 months and at 12 months are recorded.

Secondary outcomes

Best corrected visual acuity

Time frame: change from baseline in LOCS III grades at 12 months are recorded

Best corrected visual acuity of each individual is recorded

Sponsors and collaborators

Lead sponsor

Uludag University

Other

Registry information

Important dates

Study start: 2009
Primary completion: 2010
Study completion: 2011
First posted: Apr 7, 2011
Registry last updated: Apr 7, 2011

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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