HiPED - High Dose Lucentis for Persistent Pigment Epithelial Detachments in Age-related Macular Degeneration

Inclusion Criteria:

- Ability to provide written informed consent and comply with study assessments for the
full duration of the study

- Age > 50 years

- Active or recurrent neovascular age-related macular degeneration involving the fovea
on FA

- Presence of persistent fibrovascular pigment epithelial detachment on OCT following a
minimum 6 previous treatments in previous 12 months with ranibizumab and/or
bevacizumab. Patients may have received more than 12 months of anti-VEGF therapy.

- ETDRS Best Corrected Visual acuity 20/32 - 20/400

Exclusion Criteria:

- Prior treatment with verteporfin, or external-beam radiation therapy, or
transpupillary thermotherapy, Previous subfoveal focal laser photocoagulation
involving the foveal center, History of vitrectomy, submacular surgery, or other
surgical intervention for AMD, Previous participation in any studies of
investigational drugs within 1 month preceding Day 0 (excluding vitamins and
minerals) in study eye.

- Lesion Characteristics: Subfoveal fibrosis or atrophy in study eye, CNV in either eye
due to other causes, such as ocular histoplasmosis, trauma, or pathologic myopia.

- Concurrent Ocular Conditions: Concurrent eye disease in the study eye that could
compromise visual acuity (e.g., diabetic retinopathy, advanced glaucoma), Any
concurrent intraocular condition in the study eye (e.g., diabetic retinopathy or
glaucoma) that, in the opinion of the investigator, could either, Require medical or
surgical intervention during the 12-month study period to prevent or treat visual
loss that might result from that condition, or If allowed to progress untreated,
could likely contribute to loss of at least 2 Snellen equivalent lines of best
corrected visual acuity over the 12-month study period, Active intraocular
inflammation (grade trace or above) in the study eye, or history of idiopathic or
autoimmune-associated uveitis in either eye

- Current vitreous hemorrhage in the study eye

- History of rhegmatogenous retinal detachment or macular hole (Stage 3 or 4) in the
study eye

- Infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either eye

- Aphakia or absence of the posterior capsule in the study eye unless it occurred as a
result of YAG posterior capsulotomy in association with prior, posterior chamber
intraocular lens implantation.

- Uncontrolled glaucoma in the study eye (defined as intraocular pressure 30 mmHg
despite treatment with anti-glaucoma medication)

Concurrent Systemic Conditions

- Pregnancy or premenopausal women not using adequate contraception The following are
considered effective means of contraception: surgical sterilization; use of oral
contraceptives; barrier contraception with either a condom or diaphragm in
conjunction with spermicidal gel; an IUD; or contraceptive hormone implant or patch.

- History of other disease, metabolic dysfunction, physical examination finding, or
clinical laboratory finding giving reasonable suspicion of a disease or condition
that contraindicates the use an investigational drug or that might affect
interpretation of the results of the study or render the subject at high risk for
treatment complications

Other

- Inability to dilate pupils sufficient for adequate fluorescein angiography

- Inability to comply with study or follow up procedures

Subjects who meet any of the following criteria will be excluded from this study:

- Pregnancy (positive pregnancy test)

- Any other condition that the investigator believes would pose a significant hazard to
the subject if the investigational therapy were initiated