Efficacy Of 3 + PRN Versus Optical Coherence Tomography Angiography-guided 1+PRN Intravitreal Ranibizumab Injection For Neovascular Age-related Macular Degeneration

OBJECTIVE: To evaluate the safety and efficacy of 0.5mg Ranibizumab using optical coherence tomography angiography(OCTA)to monitor choroidal neovascularization(CNV)changes following a single injection following the 1 + PRN regimen and three consecutive monthly injections following the 3 + PRN regimen to treat neovascular age-related macular degeneration(n AMD),using OCTA technology to evaluate the evolution of CNV after intravitreal injection of anti-vascular endothelial growth factor(anti-VEGF).Methods: This is a prospective randomized case-control study.A total of 41 cases were collected in this study,including 41 eyes.The collected n AMD patients were randomly divided into 1 + PRN group and 3 + PRN group.All patients were treated with 0.5 mg Ranibizumab intravitreal injection.The 1 + PRN group was treated according to the 1 + PRN regimen and follow-up protocol,and the 3 + PRN group was treated with the 3 + PRN regimen and follow-up protocol.All patients were followed up for 12 months and performed monthly eye examinations.Observe the best corrected visual acuity(BCVA)and foveal retinal thickness(CMT)at 1,3,6,and 12 months after treatment.Weekly observation of CNV area and morphological changes in the 1 + PRN group,and observation of 12 after treatment in the 3 + PRN group CNV area per month.The total number of Ranibizumab injections and the incidence of adverse events related to Ranibizumab intravitreal injections during the trial period were counted at the end of follow-up.Results: There was no statistically significant difference between the basic characteristics and baseline characteristics of the 1 + PRN group and the 3 + PRN group(p> 0.05).At the end of the follow-up(12 months),the average BCVA in the 1 + PRN group increased by 18.07 letters from the baseline and 11.77 letters in the 3 + PRN group;the average CMT in the 1 + PRN group decreased from 373.07 ?m at the lower baseline to 246.27 ?m,the 3 + PRN group decreased from 304.81 ?m at baseline to 232.12 ?m;the CNV blood flow area in the 1 + PRN group decreased by 26% on average compared to the baseline,and the CNV blood flow area in the 3 + PRN group decreased by 14% on average from the baseline There was no statistically significant difference in reduction between groups(p> 0.05).There was no statistically significant difference in the average BCVA and average CMT between the 1 + PRN group and the 3 + PRN group(p> 0.05).At the end of the follow-up(12 months),the average total number of injections in the 1 + PRN group was 6.077,and the average total number of injections in the 3 + PRN group was 6.9.There was no significant difference between the two groups(p> 0.05).The consistent pattern of CNV changes in different patients in the 1 + PRN group was observed.There were no serious ocular adverse events and systemic adverse events during the follow-up period.CONCLUSION: Both 1+PRN and 3+PRN treatments for n AMD are safe and effective,and similar efficacy can be achieved with the similar number of injections over 12 months with the 1+PRN and 3+PRN regimens.The CNV changes observed by OCTA may be able to assess the correct optimal timing of injections.Data trends in CNV blood flow area and morphological changes were observed using the 1+PRN protocol,suggesting that a more active follow-up strategy could improve visual function more quickly.