Clinical Studies:


Summarized by Mrinali Gupta, MD (Retina Associates of Orange County)

Citation: Singer MA, Awh CC, Sadda S, et al. HORIZON: an open-label extension trial of ranibizumab for choroidal neovascularization secondary to age-related macular degeneration. Ophthalmology 2012; 119: 1175-1183.

Key Points

  • HORIZON was an extension study of 24 months duration after completion of the 24-month MARINA, ANCHOR, or FOCUS trials of ranibizumab versus photodynamic therapy (PDT) for choroidal neovascularization (CNV) from age-related macular degeneration (AMD)
  • Subjects were treated with ranibizumab at the investigating clinician’s discretion
  • Visual acuity decreased in all groups. In eyes treated initially with ranibizumab in the clinical trials, visual acuity decreased such that all the visual gains from the trials were lost by the end of the study. In eyes initially in the control group, treatment with ranibizumab in the HORIZON trial period resulted in visual acuity loss, but at a lower rate than during control therapy in the trials
  • The poor visual outcomes in this study likely reflect undertreatment (versus natural longer-term progression of the disease), given that significant AMD activity was noted (>30% with progression of AMD), but ranibizumab injection frequency was low (mean 4-5 ranibizumab injections per patient over 24 months)
  • Objective

    Extension study to evaluate long-term outcomes after intravitreal ranibizumab for AMD amongst patients who completed the MARINA, ANCHOR, or FOCUS* trial.

    *In the FOCUS trial, all patients received PDT (no ranibizumab-only arm)


    Open-label, multicenter, extension study of the MARINA, ANCHOR, FOCUS trials

  • Duration

    24 months (after completion, i.e. 24 months, of MARINA, ANCHOR, FOCUS trial)



Those initially treated with ranibizumab at the initial trial compared to “ranibizumab cross-over” (those treated with control in the initial trial and eligible for ranibizumab upon HORIZON baseline). Data presented relative to initial study baseline (month 0) and HORIZON baseline (month 24)


Study population

Visual acuity end-points

Mean number of injections

Anatomic outcomes